Physicians’ perspectives on estimating and communicating prognosis in palliative care: a cross-sectional survey

• Published in: BJGP open 2020-10, Vol.4 (4), p.bjgpopen20X101078
• Main Authors: Engel, Marijanne, van der Ark, Andrée, van Zuylen, Lia, van der Heide, Agnes
• Format: Article
• Language: English
• Subjects: communication; general practice; palliative care; physicians; prognosis
• ISSN: 2398-3795; 2398-3795
• DOI: 10.3399/bjgpopen20X101078

BACKGROUNDAdvance care planning (ACP) can help to enhance the care of patients with limited life expectancy. Despite physicians' key role in ACP, the ways in which physicians estimate and communicate prognosis can be improved. AIMTo determine how physicians in different care settings self-assess their performance in estimating and communicating prognosis to patients in palliative care, and how they perceive their communication with other physicians about patients' poor prognosis. DESIGN & SETTINGA survey study was performed among a random sample of GPs, hospital physicians (HPs), and nursing home physicians (NHPs) in the southwest of the Netherlands (n = 2212). METHODA questionnaire was developed that had three versions for GPs, HPs, and NHPs. Each specialism filled in an appropriate version. RESULTSA total of 547 physicians participated: 259 GPs, 205 HPs, and 83 NHPs. In the study, 61.1% of physicians indicated being able to adequately estimate whether a patient will die within 1 year, which was associated with use of the Surprise Question (odds ratio [OR] = 1.65, P = 0.042). In the case of a prognosis of