Interdisciplinary cooperation of GPs in palliative care at home: a nationwide survey in the Netherlands

Objective. To investigate the occurrence and predictors of interdisciplinary cooperation of GPs with other caregivers in palliative care at home. Design. In a prospective study among 96 general practices, the GPs involved identified all dying patients during the study period of 12 months. The GPs received an additional post-mortem questionnaire for each patient who died during the study period, and registered the healthcare providers with whom they cooperated. Multivariable logistic regression analysis was used to identify the predictors of GP cooperation with other caregivers. Setting. Second Dutch National Survey in General Practice. Subjects. A total of 743 patients who received palliative care according to their GP. Main outcome measures. Interdisciplinary cooperation between GP and other healthcare providers. Results. During the study period, 2194 patients died. GPs returned 1771 (73%) of the questionnaires. According to the GPs, 743 (46%) of their patients received palliative care. In 98% of these palliative care patients, the GP cooperated with at least one other caregiver, with a mean number of four. Cooperation with informal caregivers (83%) was most prevalent, followed by cooperation with other GPs (71%) and district nurses (63%). The best predictors of cooperation between GPs and other caregivers were the patient's age, the underlying disease, and the importance of psychosocial care. Conclusion. In palliative care patients, GP interdisciplinary cooperation with other caregivers; is highly prevalent, especially with informal caregivers and other primary care collaborators. Cooperation is most prevalent in younger patients, patients with cancer as underlying disease, and if psychosocial care is important