TY - JOUR
T1 - End-of-life communication in advanced cancer
T2 - international trends (2009-2014)
AU - Verkissen, Mariëtte N.
AU - Penders, Yolanda W. H.
AU - Onwuteaka-Philipsen, Bregje D.
AU - Moreels, Sarah
AU - Donker, G. A.
AU - Vega Alonso, Tomás
AU - van den Block, Lieve
AU - Deliens, Luc
N1 - Funding Information:
Funding Data collection was funded by the Belgian Scientific Institute of Public Health (now Sciensano), the Netherlands Institute for Health Services Research and the Regional Ministry of Health of Castile and León (Spain). The first author received funding from the European Union’s Seventh Framework Programme FP7/2007-2013 (grant agreement no. 602541).
Publisher Copyright:
© Author(s) (or their employer(s)) 2022.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - OBJECTIVE: To examine trends in end-of-life communication with people with cancer in general practice. METHODS: Mortality follow-back survey among general practitioners (GPs) in representative epidemiological surveillance networks in Belgium (BE), the Netherlands (NL) and Spain (ES) in 2009-2010 (ES: 2010-2011) and 2013-2014. Using a standardised form, GPs registered all deceased adult patients in their practice and reported for five end-of-life care topics whether they had been discussed with the patient. Non-sudden cancer deaths were included (n=2306; BE: 1233; NL: 729; ES: 344). RESULTS: A statistically significant increase was found between 2009/2010 and 2014 in the prevalence of communication about diagnosis (from 84% to 94%) and options for end-of-life care (from 73% to 90%) in BE, and in GPs' awareness of patients' preferences for medical treatment and a proxy decision-maker in BE (from 41% and 20% up to 53% and 28%) and the NL (from 62% and 32% up to 70% and 52%). Communication about options for end-of-life care and psychosocial problems decreased in the NL (from 88% and 91% down to 73%) and ES (from 76% and 77% down to 26% and 39%). CONCLUSION: Considerable change in GP-patient communication seems possible in a relatively short time span, but communication cannot be assumed to increase over time. Increasing specialisation of care and task differentiation may lead to new roles in communication for healthcare providers in primary and secondary care. Improved information sharing between GPs and other healthcare providers may be necessary to ensure that patients have the chance to discuss important end-of-life topics.
AB - OBJECTIVE: To examine trends in end-of-life communication with people with cancer in general practice. METHODS: Mortality follow-back survey among general practitioners (GPs) in representative epidemiological surveillance networks in Belgium (BE), the Netherlands (NL) and Spain (ES) in 2009-2010 (ES: 2010-2011) and 2013-2014. Using a standardised form, GPs registered all deceased adult patients in their practice and reported for five end-of-life care topics whether they had been discussed with the patient. Non-sudden cancer deaths were included (n=2306; BE: 1233; NL: 729; ES: 344). RESULTS: A statistically significant increase was found between 2009/2010 and 2014 in the prevalence of communication about diagnosis (from 84% to 94%) and options for end-of-life care (from 73% to 90%) in BE, and in GPs' awareness of patients' preferences for medical treatment and a proxy decision-maker in BE (from 41% and 20% up to 53% and 28%) and the NL (from 62% and 32% up to 70% and 52%). Communication about options for end-of-life care and psychosocial problems decreased in the NL (from 88% and 91% down to 73%) and ES (from 76% and 77% down to 26% and 39%). CONCLUSION: Considerable change in GP-patient communication seems possible in a relatively short time span, but communication cannot be assumed to increase over time. Increasing specialisation of care and task differentiation may lead to new roles in communication for healthcare providers in primary and secondary care. Improved information sharing between GPs and other healthcare providers may be necessary to ensure that patients have the chance to discuss important end-of-life topics.
KW - cancer
KW - communication
KW - social care
UR - http://www.scopus.com/inward/record.url?scp=85134083266&partnerID=8YFLogxK
U2 - 10.1136/bmjspcare-2019-001999
DO - 10.1136/bmjspcare-2019-001999
M3 - Article
C2 - 32341055
AN - SCOPUS:85134083266
SN - 2045-435X
VL - 12
SP - e236-e247
JO - BMJ Supportive & Palliative Care
JF - BMJ Supportive & Palliative Care
IS - e2
ER -