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Open Access Research article

GPs' views on transfer of information about terminally ill patients to the out-of-hours co-operative

Bart Schweitzer1*, Nettie Blankenstein1, Maartje Willekens2, Elmi Terpstra2, Paul Giesen2 and Luc Deliens34

Author Affiliations

1 Department of General Practice, and EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

2 Centre for Quality of Care Research, Radboud University, Nijmegen, The Netherlands

3 Department of Public and Occupational Health, and EMGO Institute of Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands

4 End-of-Life Care Research Group, Vrije Universiteit Brussels, Belgium

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BMC Palliative Care 2009, 8:19  doi:10.1186/1472-684X-8-19

Published: 22 December 2009

Abstract

Background

In the Netherlands, the increase in of out-of-hours care that is provided by GP co-operatives is challenging the continuity of care for the terminally ill in general practice. Aim of this study is to investigate the views of general practitioners (GPs) on the transfer of information about terminally ill patients to the GP co-operatives. GPs were asked to give their view from two different perspectives: as a GP in their daily practice and as a locum in the GP co-operative.

Methods

Retrospective web based questionnaire sent to all 424 GPs in the Amsterdam region.

Results

With a response rate of 42%, 177 physicians completed the questionnaire. Transfer of information to the GP co-operative about most of their terminally ill patients was reported by 82% of the GPs and 5% did not do so for any of their patients. A faster than foreseen deterioration of the patient's situation was the most frequently reported reason for not transferring information.

Of those who transferred information to the GP co-operative, more than 95% reported that they provided information about the diagnosis and terminally ill status of the patient. Information about medication, patient wishes regarding treatment, and prognosis was reported by respectively 90%, 87%, and 74% of the GPs. Less than 50% of the GPs reported that they transferred information about the patient's awareness of both the diagnosis and the prognosis, about the psychosocial context, and intolerances.

In their role as locum, over 90% of the GPs wanted to receive information about the diagnosis, the terminally ill status of the patient, the medication and the patient's wishes regarding treatment.

Conclusions

Although most GPs reported that they transferred information about their terminally ill patients to the GP co-operative, the content of this information varies considerably. Only 21% of the GPs, working out of hours as a locum, were satisfied with the quality of the information transferred.