Appendix 3 Details of studies references updated 3 June

Appendix 3 Details of studies

Study, author, date & location Study design & aim Setting, sample size & participant

characteristics

Methods Quality

assessment

3.1 Patient factors

Early identification of palliative

care needs by family physicians:

A qualitative study of barriers

and facilitators from the

perspective of family

physicians,

community nurses, and patients

Beerneart,26 2014

Belgium.

Design: Qualitative

Aim: To explore the barriers to

and facilitators of the early

identification by family physicians

of the palliative care needs

Setting: Flanders region of Belgium

Participants: GPs, Palliative care and

general nurses working in the

community, eighteen patients

Qualitative: interviews and focus

groups with semi-

structured discussion guide

CASP

8/10

Palliative care by family

physicians in the 1990s.

Resilience amid reform

Burge,20 2001

Canada

Qualitative

Aim: to ascertain Family physician

perceptions of providing palliative

care in context of shrinking

hospital resources.

Setting: College of Physicians and

Surgeons, Nova Scotia.

Purposive sampling. 5 focus groups with

25 male and female GPs.

Focus groups

Audiotaped and transcribed

Thematic analysis

CASP 8/10

Home visits by family physicians

during the end-of-life: Does

patient income or residence

play a role?

Burge, 21 2005

Canada

Cohort

Aim: to examine the association

between patient income and

residence and the receipt of

Family Physician (FP) home visits

during the end-of-life among

patients with cancer

Setting: Data linkage from 3

administrative health databases and

Statistics Canada census records in

Ontario, Canada:

Participants: Registered patients

(n = 7212) who died between 1992 and

1997, with a confirmed cancer diagnosis,

≥ 18 years, and have a valid provincial

health insurance number.

Linked data set.

Studied relationship between income

and likelihood of a home visit in the

last six months of life or from

diagnosis to death if survival <6

months.

Control for neighbourhood income,

sex, year of death, age, cancer cause

of death, region of residency, the

NOS Cross-

sectional:

8/10

Supplementary material BMJ Support Palliat Care

doi: 10.1136/bmjspcare-2019-002109–11.:10 2020;BMJ Support Palliat Care, et al. Rhee JJ

number of visits made to a medical

specialist,

Understanding the provision of

palliative care in the context of

primary health care: Qualitative

research findings from a pilot

study in a community setting in

Chile.

Cameron,27 2009

Chile

Design: Hermeneutic

phenomenology

Aim: Understand the provision of


primary health care (PHC).

Examine the PHC milieu as

a propitious one in which to

provide palliative care in a

developing country. Generate

opportunities for international

collaboration with Chile in areas

of public health, nursing and

palliative care.

Setting: PHC centres in

the Chiguayante district, Chile.

Population served – 33,000. Majority

low-income demographic.

Participants: 3 adults receiving palliative

care through the PHC, 2 family members,

2 PHC professionals (1 physician, 1

nurse).

Unstructured face-to-face interviews

and observation of patients and their

families as well as doctors and

practice nurses.

CASP

10/10

Involvement of general

practitioners in palliative cancer

care: A qualitative study

Dahlhaus,31 2013

Germany

Qualitative

Aim: to explore general

practitioners' perceptions of their

involvement in palliative cancer

care and the constraints they

confront

Setting: General Practice

Participants: Purposive sampling. 13 GPS

Qualitative interview schedule asking

open ended questions about last

palliative patient they had cared for.

Analysis: qualitative content analysis

according to Mayring

CASP 9/10

Barriers to home care for

terminally ill Turkish and

Moroccan migrants, perceived

by GPs and nurses; a survey

De Graaff,17 2008

Netherlands

Design: cross-sectional survey

Aim: (A) What experiences and

perceptions do

general practitioners and home

care nurses have with regard to

home care for terminally ill

Turkish and Moroccan migrants

and their families in the

Netherlands?

(B) What factors, according to

them, influence the access to and

Setting: GPs and home care nurses

working in economically deprived areas

of urban areas of Netherlands where

concentrations of Turks and Moroccans

are known to reside.

Participants: 124/326 invited

nurses (29%); 352/586 (60%) GPs

Survey with closed questions (yes/no

type) and open, free text responses

NOS Cross-

Sectional

6/10



use of home care in

the terminal phase?

Reasons for hospitalisation at

the end of life: Differences

between cancer and non-cancer

patients

De Korte-Verhoef,18 2014

The Netherlands

Cross-sectional

Patients of participating GPs who

died of either cancer or non-

malignant disease and were

hospitalised within 3 months of

death.

Setting:Dutch general practice

Participants: 317 Deceased patients of

Dutch GPs

Patients identified from retrospective

reporting from a network of GPs, who

died and had been hospitalised within

3 months of death.

NOS Cross

Sectional

5/10

Burden for family carers at the

end of life; A mixed-method

study of the perspectives of

family carers and GPs


The Netherlands

Cross-sectional

Aimed to assess the link between

hospitalisation of a patient in the

last week of life and carer burden

Setting: Dutch General Practice

1. Quantitative questionnaire study

among 194 GPs and 74 family carers of

patients who died non-suddenly.

2. In-depth interviews were conducted

with 18 family carers.




3 months of death.

NOS Cross-

Sectional

5/10

Palliative care provided by GPs:

The carer's viewpoint

Hanratty,22 2000

United Kingdom

Cross sectional

Aim: to explore bereaved carers'

views of the palliative care

provided by GPs

Setting: General practice

Participants: Bereaved carers who

registered a patient death from cancer in

a North Yorkshire district. 139/234 carers

who had registered a death from cancer

Postal survey using: the VOICES

survey and demographic questions

NOS Cross-

sectional: 5/5

(not all

elements of

assessment

relevant).

Rural general practitioner

perspectives of the needs

of Mãori patients requiring

palliative care.

Lawrenson,28 2010

New Zealand

Design: Cross-sectional survey

Aim: to identify rural GP


of Mãori patients receiving

palliative care and what actions

Setting: Rural general practitioners

Participants 186/440 rural GPs sent the

survey

Postal survey with specifically

designed questionnaire

NOS: Cross

Sectional

2/5 (not all

elements of

assessment

relevant)



the GPs had undertaken to meet

these needs.

Coordination of care for

individuals with advanced

progressive conditions: A multi-

site ethnographic and serial

interview study

Mason,23 2013

United Kingdom

Qualitative

Aim: to identify how and what

extent end of life care is

coordinated in generalist care.

Setting: Generalist clinical settings

producing three parallel case studies: an

acute admissions unit in a regional

hospital, a large general practice, and a

respiratory outpatient service.

Participants: 3 UK generalist clinical

settings.

A total of 56 patients, 25 family carers

and 17 clinicians yielded 198 interviews.

Ethnographic observations in each

setting were conducted for 22 weeks.

followed by semi-structured

interviews. Interviews every 8-12

weekly intervals with patients and or

carer and single interviews with

health professionals

CASP

Qualitative:

9/10

The role of primary care

physicians in advanced cancer

care: Perspectives of older

patients and their oncologists

O'Toole,30 2009

USA

RCT and Cross sectional

Aim: to identify age- related

differences in patient and

oncologist perspectives on

involvement of GPs

Setting: Teaching hospital-based cancer

clinics

Participants: 39 oncologists and 357

Patients who had an oncologist and PCP

enrolled 2 to 3 months after an advanced

cancer diagnosis

Survey - demographics and attitudes

to involvement of GP in ongoing care.

Patients were already part of a RCT

looking at a support intervention.

NOS Cross-

sectional:

2/10 (not all

elements of

assessment

relevant)

Palliative care service use in four

European countries: A cross-

national retrospective study via

representative networks of

general practitioners

Pivodic,25 2013

Belgium, Netherlands, Italy,

Spain

Cross sectional

Aim: to examine the number of

people receiving palliative care in

the last 3 months of life in 4

European countries, and the

factors associated with receiving

palliative care patients.

Setting: Epidemiological surveillance

networks of GPs in Belgium, the

Netherlands, Italy, and Spain

Participants: GPs who register patient

deaths. Sample size not required as all

non-sudden death patients included

Cross-national retrospective study

Over two years (2009-2010), GPs

registered weekly all deaths of

patients (>18 years) in their practices

and the care they received in the last

three months of life using a

standardized form. Sudden deaths

were excluded. A total of 4,466

deaths were studied.

NOS Cross-

sectional:

5/5 (not all

elements of

assessment

relevant)



Barriers and facilitators to the

receipt of palliative care for

people with dementia: The

views of medical and nursing

staff

Ryan,24 2012

UK

Qualitative

Aim: explore the experiences of

health care practitioners working

in palliative care in order to

establish the issues relating to end

of life care for people with

dementia

Setting: Hospital, general practice,

hospice and specialist palliative care unit

Participants: Eight focus groups and four

individual interviews.

n = 58 palliative care GPS, nursing and

allied health professionals.

Focus groups and individual

interviews

Recorded and transcribed verbatim.

Transcripts read by 3 authors.

Computer software used to handle

data.

CASP

Qualitative:

10/10

How palliative care of cancer

patients is organised between a

University Hospital and primary

care in Finland

Tasmuth,28 2006

Finland

Cross sectional

Aim: to describe how palliative

care functions in practice in the

university hospital area; the need

for palliative care in primary care;

the problems related to

cooperation between the hospital

and primary care; the need for

training in palliative care

Setting: University Central Hospital

(University Hospital) and primary care

Participants: GPs and patients. 110

patients agreed to participate, 8 died

before survey; 102 at first interview; (71

- 70% patients one week later, 45 - 65%

one month after than;60 - 60%; 15 - 52%

at 6 months; 6 mths later 6 out of 9

43 GPs for 61 patients (60% response)

Patients were interviewed by phone

using a structured questionnaire. A

survey questionnaire was used to

collect data from the primary care

physic ians.

NOS Cross-

sectional:

5/10

3.2 Personal GP factors

Early identification of palliative

care needs by family physicians:

A qualitative study of barriers

and facilitators from the

perspective of family

physicians,

community nurses, and patients

Beerneart,26 2014

Belgium.

Design: Qualitative

Aim: To explore the barriers to

and facilitators of the early

identification by family physicians

of the palliative care needs

Setting: Flanders region of Belgium

Participants: GPs, Palliative care and

general nurses working in the

community, eighteen patients

Qualitative: interviews and focus

groups with semi-

structured discussion guide

CASP

8/10








Chile.

Cameron,27 2009

Chile

Design: Hermeneutic

phenomenology











palliative care.








nurse).




practice nurses.

CASP

10/10

Factors enabling shared care

with primary healthcare

providers in community

settings: The experiences of

interdisciplinary palliative care

teams.

DeMiglio,39 2012

Canada

Design: Case study. Semi-

structured focus groups. Adapted

thematic content analysis.

Aim: Examine how palliative care

teams negotiate barriers in order

to share mutual responsibility for

patients with primary healthcare

providers

Setting: Southern Ontario, Canada, Local

Health Integration Networks (LHIN).

Participants: 5 palliative care teams

consisting of student learners on

rotation, community nurses and the

clinicians themselves.

Semi-structured focus groups and

interviews.

CASP 8/10

Obstacles to the delivery of

primary palliative care as

perceived by GPs

Groot,38 2007

Netherlands

Cross sectional

Aim: From a previous qualitative

study using focus groups, we

learned that GPs experienced

barriers on three different levels,

namely: personal, relational and

organizational. We aimed to

identify the frequency of the

various barriers and its

determinants.


Participants: 320 GPs out of 514 (62%)

GPs posted written questionnaires

together with a covering letter

explaining the aims of the study and a

stamped addressed return envelope.

NOS Cross-

sectional:

4/10 (not all

elements of

assessment

relevant)



Palliative care in Western

Australia: an assessment of

information and support needs

McConigley,34 2001

Australia

Cross sectional study

Aim: To explore the perspectives

of nurses from nursing homes,

home care and hospitals, and

family physicians concerning

hospital admissions at the end of

life and the circumstances in

which they consider them to be

justified

Setting: homes of GPs and nurses.

Participants: Rural nurses & allied health

= 55.4%. GPs = 50%

Total sample response rate -= 52%

Postal questionnaire.

Descriptive statistics for demographic

data.

Mann Whitney U test to analyse

group differences.

NOS Cross-

sectional:

8/10

General practitioners and their

possible role in providing

spiritual care: A qualitative

study

Murray,36 2003

United Kingdom

Qualitative

Aim: A) Do GPs perceive that they

have a role in providing spiritual

care? and B) What do GPs

perceive as helping and hindering

them in assessing spiritual needs

and providing spiritual care?

Setting: General practices

Participants: General practitioners (GPs)

of 40 patients with life-threatening

illnesses over the course of the last year

of life.

Three monthly interviews of GPs of

patients with advanced heart failure

or lung cancer

CASP

Qualitative:

8/10

General practitioners’ attitudes

to palliative care: a Western

Australian rural perspective.

O’Connor,32 2006

Australia

Design: Semi-structured

interview.

Aim: To understand GPs’ attitudes

to palliative care in rural WA, what

factors contribute to GPs

attitudes to palliative care in rural

WA and what are the perceived

barriers to the provision of

palliative care in rural WA.

Setting: Rural WA.

Participants: 10 registered GPs located

within the Greater Bunbury Division of

General Practice. 8 Males, 2 females.

Semi-structured interview, open-

ended questions.

CASP 9/10



General Practitioners'

experiences of bereavement

care and their educational

support needs: a qualitative

study

O'Connor,33 2014

Australia

Cross-sectional

Aim: to explore GPs

understandings of bereavement

care and their education and

professional development needs

in relation to bereavement care


Participants: 19 GPS were participated in

exploratory semi structured interview

Semi structured interviews, social

constructionist methodology

CASP

Qualitative:

9/10






Pivodic,25 2013


Spain

Cross sectional






















NOS Cross-

sectional:

5/5 (not all

elements of

assessment

relevant)

What influences the willingness

of community physicians to

provide palliative care for

patients with terminal cancer?

Evidence from a nationwide

survey

Peng,40 2013

Taiwan

Cross sectional

Aim: A) to identify community

physicians’ willingness to provide

palliative care in their

communities when they

encounter patients with terminal

cancer and B) to investigate the

factors that influence their

willingness to provide palliative

care.

Setting: General practices in

metropolitan, regional and rural Taiwan

Participants: 708 community physicians

who were potential pilots to provide

palliative care. Four hundred and ten

valid questionnaires (58.0%) were

retrieved and analysed.

A structured questionnaire NOS Cross

sectional 6/9

Attitudes and barriers to

involvement in palliative care by

Australian urban general

practitioners.

Rhee,35 2008

Design: Cross-sectional

Aim: To determine the level of

participation of Australian urban

GPs in palliative care and to

determine the main barriers

facing them in providing this care.

Setting: Sydney, Australia. 50% of surveys

sent to lower socioeconomic (SES) areas

and 50% sent to higher SES areas of

Sydney.

Participants: 500 GPs sent surveys. 269

returned.

Cross sectional postal survey.

Questions formulated with a panel of

experts in palliative care or GPs with

special interests in palliative care.

CASP 10/10



Australia

Barriers and facilitators to the

receipt of palliative care for

people with dementia: The

views of medical and nursing

staff.

Ryan,24 2012

United Kingdom

Design: Focus group interviews

Aim: Explore the experiences of

health care practitioners working

in palliative care and establish the

issues relating to end of life care

for people with dementia.

Setting: Include acute hospitals, general

practices, hospices and specialist

palliative care unit in wo cities in the UK.

Participants: Consultants, junior doctors,

GPs, nurses, nurse specialists, allied

health professionals. Participants n = 58.

Semi-structured focus group

interviews.

CASP 9/10

Heartsink encounters: a

qualitative study of end-of-life

care in out-of-hours general

practice

Taubert et al,37 2011

United Kingdom

Qualitative

Aim: to establish how prepared

GPs who work regular out-of-

hours shifts feel when dealing

with end-of-life issues in palliative

care patients, what they thought

about seeing such patients and

whether they considered

themselves emotionally equipped

to do so.


Participants: GPs who worked regular

out-of-hours shifts - 9 out of 60.

Semi-structured interviews

A detailed analysis of transcripts using

Interpretative Phenomenological

Analysis was undertaken

CASP

Qualitative:

8/10

3.3 GP Practice factors

Delivery strategies to optimize

resource utilization and

performance status for patients

with advanced life-limiting

illness: Results from the

"palliative care trial"

Abernethy,41 2013

Australia

RCT

Aim: to improve on current

models of service provision of

palliative care.

Setting: Community-based palliative care

service

Participants: 461 patients and 228 GPs in

105 practices

Cluster randomised by GP practice:

Study 1: 3:1, n=461

Case conferencing n=358; received

n=167 (47%)

No case conferencing n=103; control

received n=0

Study 2: 1:1, n=461

JDAD 6/8



GP education n= 195; received n=174

(89%)

No GP education n=266; control

received n=1 (<1%)

Palliative care for older people –

exploring the views of doctors

and nurses from different fields

in Germany

Brueckner,49 2009

Germany

Qualitative

Aim: to explore various health

providers' perceptions

and attitudes concerning the

delivery of palliative care to older

persons in Germany.

Setting: Geriatric institutions and

referring GPs in Hannover, Germany

Participants: Twenty-nine participants in

seven focus groups (general

practitioners, geriatricians, palliative care

physicians, palliative care nurses and

general nurses).

Qualitative, focus groups CASP

9/10




Burge,21 2001

Canada

Qualitative




hospital resources.





Focus groups


Thematic analysis

CASP 8/10

Roles, service knowledge and

priorities in the provision of

palliative care: A postal survey

of London GPs

Burt,48 2006

United Kingdom

Cross sectional


practitioners’ (GPs) current

involvement in and attitudes

towards the provision of palliative

care in primary care.


Participants: Purposive sampling. 620

postal surveys were posted to GPS and

356 (57%) completed questionnaires.

Postal survey of 356 London-based

GPs,

Pearson chi squared tests and

multiple linear regression was used in

data analysis

NOS Cross-

sectional: 4/5

(not all

elements of

assessment

relevant)

Barriers to home care for

terminally ill Turkish and

Moroccan migrants, perceived

by GPs and nurses; a survey

De Graaff,17 2008

Netherlands

Design: cross-sectional survey

Aim: (A) What experiences and

perceptions do

general practitioners and home

care nurses have with regard to

home care for terminally ill

Turkish and Moroccan migrants

Setting: GPs and home care nurses

working in economically deprived areas

of urban areas of Netherlands where

concentrations of Turks and Moroccans

are known to reside.

Survey with closed questions (yes/no

type) and open, free text responses

NOS Cross-

Sectional

6/10



and their families in the

Netherlands?

(B) What factors, according to

them, influence the access to and

use of home care in

the terminal phase?

Participants: 124/326 invited

nurses (29%); 352/586 (60%) GPs

Burden for family carers at the

end of life; A mixed-method

study of the perspectives of

family carers and GPs


The Netherlands

Cross-sectional

Aimed to assess the link between

hospitalisation of a patient in the

last week of life and carer burden

Setting: Dutch General Practice

1. Quantitative questionnaire study

among 194 GPs and 74 family carers of

patients who died non-suddenly.

2. In-depth interviews were conducted

with 18 family carers.




3 months of death.

NOS Cross-

Sectional

5/10






teams.

DeMiglio,39 2012

Canada








providers








interviews.

CASP 8/10

Information transfer to out-of-

hours co-operatives: a survey of

general practitioners' views in

relation to palliative patients

Kiely,50 2013

Ireland

Cross-sectional

Aim: (A) Assess views of GPs on

the importance of developing a

formalised method of information

transfer,(B) Assess the type of

information consider important or

necessary (C) describe perceived

current barriers to care provision

for PC patients and (D) to provide

Setting: GPs registry in the Irish Medical

Directory in the southwest of Ireland.

Participants: Questionnaire sent to 414

GPs. 214 (52% of the 414) responded to

the survey.

Postal questionnaire with stamped

addressed envelope. A reminder was

sent.

NOS Cross-

sectional:

7/10



a evidence base to develop an

electronic palliative care summary

An analysis of calls to an out-of-

hours palliative care advice line

Lloyd-Williams,45 2003

United Kingdom

Cross sectional study

Aim: to evaluate the use of an

after-hours advice line for non-

registered patients.

Setting: Hospital

Participants: A senior member of nursing

staff or medical staff answered all calls.

98 calls were received. The majority of

callers were GPs (55%) and community

nurses (34%).

Analysis of after hour calls for all

palliative care patients

NOS Cross-

sectional: 2/5

(not all

elements of

assessment

relevant)

Do case conferences between

general practitioners and

specialist palliative care services

improve quality of life? A

randomised controlled trial

(ISRCTN 52269003)

Mitchell,42 47 2008

Australia

RCT

Aim: Do case conferencing

improve QOL for palliative care?

Setting: General practice and hospital

Intervention: case conference vs usual

care

Participants: 159 palliative care patients.

A multi-centred randomised

controlled trial of specialist- GP case

conferences, with the GP

participating by teleconference, or

usual care and communication

methods.

An intention-to-treat analyses were

conducted using recruitment, and

time of death, as fixed time points.

JDAD: 3/8

.

Case conferences between


specialist teams to plan end of

life care of people with end

stage heart failure and lung

disease: an exploratory pilot

study

Mitchell,43 48 2014

Australia

Controlled before and after

Aim: to assess the effectiveness of

case conferences between

specialist teams and GP in

improving patient outcomes for

people with end stage heart

failure or lung disease.


Intervention: Case conference between

GP, palliative care physician and case

management nurse.

Participants: Twenty-three case

conferences involving 21 GPs were

conducted between November 2011 and

November 2012

Rates of service utilisation

(emergency department [ED]

presentations, ED discharges back to

home, hospital admissions, and

admission length of stay) before and

after case conference were calculated

NOS Cohort

4/5 (not all

elements of

assessment

relevant).



Providing end-of-life care in

general practice: findings of

a national GP questionnaire

survey.

Mitchell,47 2016

United Kingdom

Web survey – Qualitative analysis

of free text questions

Aims: Describe-

What is the current experience of

GPs delivering EOLC?

What barriers and facilitators do

they identify to the provision of

EOLC?

Setting:

General practitioners responding to a

national online survey.

Participants: 516 GPs widely distributed

through England, some from Scotland

and Wales.

Questionnaire with free text

responses

CASP

Qualitative

8/10






survey

Peng,40 2013

Taiwan

Cross sectional









care.








A structured questionnaire NOS Cross

sectional 6/9

End-of-life care from the

perspective of primary care

providers.

Silveira, 51. 2012

USA

Qualitative

Aim: To explore the factors

influencing primary care

providers’ ability to care for their

dying patients in Michigan, USA

Setting: Primary care practices (General

internal medicine and primary care) in

south-east Michigan

Participants: 28 Primary care

practitioners and 22 clinical support staff

including 10 registered nurses in 16 focus

groups

In-depth focus groups CASP

Qualitative

10/10

Improving generalist end of life

care: National consultation with

practitioners, commissioners,

academics, and service user

groups

Shipman,46 2008

Qualitative

Aim: to identify major concerns in

the commissioning, provision,

research and use of generalist end

of life care

Setting: Primary and secondary care,

specialist palliative care, and academic

and voluntary sectors in England and

Scotland.

Participants: Healthcare practitioners,

commissioners, academics, and

Qualitative approach: a national

consultation and prioritising exercise

using a modified form of the nominal

group technique.

CASP

Qualitative:

8/10



United Kingdom representatives of user and voluntary

groups. 74% of those invited (210/285)

participated.

GP and nurses' perceptions of

how after hours care for people

receiving palliative care at home

could be improved: a mixed

methods study

Tan,44 2009,

Australia


Aim: To identify barriers to the

provision of after-hours palliative

Care in Australian general

practice.

Setting: three Divisions of General

Practice (one each of urban, regional

and rural areas)

Participants: 114/524 (22%) GPs and

52/112 (43%) community nurses

Questionnaire based on

previous qualitative study.

NOS Cross-

sectional

2/5 (not all

elements of

assessment

relevant).

3.4 Relational factors

Interdisciplinary cooperation of

GPs in palliative care at home: A

nationwide survey in the

Netherlands

Borgsteede,54 2007

Netherlands


To investigate

the prevalence and predictors of

interdisciplinary cooperation of

GPs with other caregivers in

palliative care at home.

Setting: Second Dutch survey in General

Practice

Participants: 743 decedents in 96

practices of 2143 deaths, who received

palliative care.

Questionnaire NOS Cross-

sectional

6/9




in Germany

Brueckner,49 2009

Germany

Qualitative



and attitudes concerning the


persons in Germany.







general nurses).


9/10



Rural general practitioner


of Mãori patients requiring

palliative care.

Lawrenson,29 2010

New Zealand


Aim: to identify rural GP


of Mãori patients receiving

palliative care and what actions

the GPs had undertaken to meet

these needs.

Setting: Rural general practitioners

Participants 186/440 rural GPs sent the

survey

Postal survey with specifically

designed questionnaire

NOS: Cross

Sectional

2/5 (not all

elements of

assessment

relevant)





interview study

Mason,23 2013

United Kingdom

Qualitative










settings.










CASP

Qualitative:

9/10

Cancer Patients Use Hospital-

Based Care Until Death: A

Further Analysis of the Dutch

Bone Metastasis Study

Meeuse,55 2011

Netherlands


study) Multiple Questionnaires d

uring RCT of radiation therapy for

bony metastases

Aim: To describe health

care utilization in cancer

patients with bony metastases,

and independent predictors

for that utilisation

Setting: Dutch Oncology and community

service providers

Participants: 661/860 (77%) potential

respondents

Multilevel logistic regression. NOS Cross-

Sectional

10/10






O’Connor,32 2006

Australia


interview.








Setting: Rural WA.





ended questions.

CASP 9/10






Pivodic,25 2013


Spain

Cross sectional






















NOS Cross-

sectional:

5/5 (not all

elements of

assessment

relevant)

An insight into the delivery of a

palliative approach in

residential aged care: The

general practitioner

perspective.

Phillips52 2009,

Australia

Design: Qualitative study

Aim: To investigate GP’s

perceptions and

understanding of a


residential aged care.

Setting: Australian general practice

Participants: Convenience sample of

Thirteen GPs

Qualitative – Focus groups CASP

8/10

Healthcare professional’

perceptions toward inter-

professional collaboration in

palliative home care: a view

from Belgium.

Pype,56 2013

Belgium

Design: qualitative

Aim: to describe the views of GPs

toward inter-professional

teamwork in palliative care.

Setting: Primary care in urban and

rural Belgium

Participants: 29 participants purposively

recruited from three

groups: GPs, Primary Health Care Team

members, Continuing medical education

providers

Five focus groups, inductive analysis CASP

9/10



Finding common ground to

achieve a “good death”: family

physicians working with

substitute decision-makers of

dying patients. A qualitative

grounded theory study.

Tan,57 2013

Canada

Design: Qualitative

Aim: to describe Canadian family

physicians’ experiences of conflict

with substitute decision-makers

of dying patients to identify

factors that may facilitate or

hinder the end-of-life decision-

making process.

Setting: Edmonton, Canada

Participants: Purposive sample of eleven

urban GPs

Individual semi-structured

interviews, Analysis using Grounded

theory methodology.

CASP

9/10





methods study

Tan,44 2009,

Australia





practice.



and rural areas)





NOS Cross-

sectional

2/5 (not all

elements of

assessment

relevant).

Promoting patient centred

palliative care through case

conferencing

Shelby-James,53 2007

Australia

Design: Cross- sectional

descriptive

Aim: To describe the

characteristics of case

conferences between general

practitioners and specialised

palliative care services (SPCS)

Setting Community specialist/GP case

conferences

Participants: 461 patients of 230 GPs

were randomised to case conference vs

not.

Cross-sectional exploratory study of

selected characteristics of the case

conferences

NOS Cross-

sectional

5/5 (not all

elements of

assessment

relevant).



3.5 Coordination of care




in Germany

Brueckner,49 2009

Germany

Qualitative





persons in Germany.







general nurses).


9/10






Chile.

Cameron,27 2009

Chile

Design: Hermeneutic

phenomenology











palliative care.








nurse).




practice nurses.

CASP

10/10




Dahlhaus,31 2013

Germany

Qualitative





confront








CASP 9/10

A national facilitation project to

improve primary palliative care:

Impact of the Gold Standards

Framework on process and self-


Aim: to describe the general

practices that participated in the


Intervention: The Gold Standards

Framework (GSF) for Palliative Care

Improvement on a self-report

questionnaire on practices’ provision

of palliative care and use of the GSF

NOS Cross-

sectional:

6/10



ratings of quality

Dale,60 2009

United Kingdom

GSF programme in 2003–5 and

the changes in process and

perception of quality that

occurred in the year following

entry into the programme, and to

identify factors associated with

the extent of change.

Participants: 837 practices expressed

interest in participation, of which 1455

(79.2%) registered for participation. Of

these, 1305 (89.7%) completed a

baseline questionnaire and 955 (73.2%)

submitted at least one follow-up

questionnaire.

Developing a framework for

primary palliative care services.

Daniels,58 2001

United Kingdom

Design: Mixed methods design

Aim: to evaluate current care

provision and explore methods of

developing palliative care services

in general practice.

Setting: Single urban general practice

Participants: 21 team members

associated with the general practice, 22

patients and their carers identified from

a records search.

Phase one: multiple team meetings

Phase two: questionnaires and

individual interviews with team

members to facilitate critical thinking

about palliative care service

provision.

CASP

9/10




patients


Netherlands

Cross-sectional





death.



Dutch GPs




3 months of death.

NOS Cross

Sectional

5/10






teams.

DeMiglio,39. 2012

Canada








providers








interviews.

CASP 8/10



Shared care: The barriers

encountered by community-

based palliative care teams in

Ontario, Canada

DeMiglio,72 2012

Canada

Qualitative

Aim: to explore barriers to views

and experiences of community

based palliative care teams about

facilitators and barriers to shared

care with community based

primary care teams.

Setting: community-based palliative care

Participants: five community-based

palliative care teams and six key-

informants

Thematic analysis.

Synthesis of data using a 3-I

framework,

CASP 8/10

Experiences, knowledge and

opinions on palliative care

among Romanian general

practitioners.

Dumitrescu,77 2005

Design: Multi-choice

questionnaire – self assessment.

Aim: Assess experience,

knowledge and opinions of

Romanian GPs on palliative

healthcare in Romania.

Setting: 5 districts of Romania which

were representative of the nation in

areas of male/female ratio and death

rate. The authors noted that the

urban/rural proportion in the districts

chosen was not representative of the

nation.

Participants: 1283 general practitioners,

71% response rate.

Multi-choice questionnaires CASP 7/10

Cooperating with a palliative

home-care team: Expectations

and evaluations of GPs and

district nurses

Goldschmid,74 2005

Denmark

Cross sectional

Aim: to investigate whether GPs

and district nurses anticipated

and experienced benefits to

patients from the contact to the

palliative home-care team,

whether they learnt aspects of

palliative care from the contact,

and to assess their satisfaction in

cooperating with the home-care

team.


Participants: 82 GPs and 163 district

nurses received questionnaire 1, and 75

(91%) GPs and 148 (91%) district nurses

completed T1 143 GPs (82%) and 101

district nurses (76%) completed T2.

A palliative home-care team has been

established and make patient visits on

a regular basis and proposed

treatment changes to the GP and

district nurse.

At the home conference (Ti). the GP

and district nurse were given a short

questionnaire. A second, partly

different questionnaire was sent to

them one month later (T2).

NOS Cross-

sectional: 3/5

(not all

elements of

assessment

relevant).

General practitioners (GPs) and

palliative care: Perceived tasks

and barriers in daily practice

Groot,70 2005

The Netherlands

Qualitative

Aim: to investigate GPs' task

perception and barriers involved

in palliative care


Participants: 3 focus groups of GPs, The

size of the groups varied from four to

eleven.

Focus group interviews to discuss the

tasks and barriers encountered in

providing palliative care.

Systematic content analysis was

performed

CASP 9/10



Palliative care provided by GPs:

The carer's viewpoint

Hanratty,22 2000

United Kingdom

Cross sectional

Aim: to explore bereaved carers'

views of the palliative care

provided by GPs


Participants: Bereaved carers who

registered a patient death from cancer in

a North Yorkshire district. 139/234 carers

who had registered a death from cancer

Postal survey using: the VOICES

survey and demographic questions

NOS Cross-

sectional: 5/5

(not all

elements of

assessment

relevant).

Doctors' perceptions of

palliative care for heart failure:

Focus group study

Hanratty,59 2002

United Kingdom

Qualitative

Aim: To identify doctors'

perceptions of the need for

palliative care for heart failure

and barriers to change

Setting: UK multiple specialties

Participants: Seven focus groups of

doctors including two GP groups. (10

GPs, 8 male)

Focus groups CASP 9/10

Palliative care referral practices

and perceptions: The divide

between metropolitan and non-

metropolitan general

practitioners.

Johnson,67 2011

Australia

Cross-sectional

Aim: To assess GPs' perceptions

and specialist palliative care

referral practice for their patients

with advanced cancer and

differences between

metropolitan and non-

metropolitan GPs.

Setting: Australian General practice

Participants: Stratified random sample of

1680 Australian GPs in different

geographic settings

Postal questionnaire NOS Cross-

sectional

7/10

Information transfer to out-of-

hours co-operatives: a survey of

general practitioners' views in

relation to palliative patients

Kiely, 50 2013

Ireland

Cross-sectional

Aim: (A) Assess views of GPs on

the importance of developing a

formalised method of information

transfer,(B) Assess the type of

information consider important or

necessary (C) describe perceived

current barriers to care provision

for PC patients and (D) to provide

an evidence base to develop an

electronic palliative care summary

Setting: GPs registry in the Irish Medical

Directory in the southwest of Ireland.

Participants: Questionnaire sent to 414

GPs. 214 (52% of the 414) responded to

the survey.

Postal questionnaire with stamped

addressed envelope. A reminder was

sent.

NOS Cross-

sectional:

7/10



'Now nobody falls through the

net': Practitioners' perspectives

on the Gold Standards

Framework for community

palliative care

King,62 2005

United Kingdom

Qualitative study.

Aim: A) to explore experiences of

key members of the primary

health care team in practices

implementing the GSF

B) to examine how the GSF

framework was integrated into

the daily life of a practice

C) to examine whether

practitioners saw it as succeeding

in meeting their aspirations for

community palliative care

Setting: General practice and home in

four separate geographical areas in

Scotland and the Nth of England

Participants: Two practices using GSF and

two practices not using GSF in each of the

4 areas (15 practices in total). 68

Gps, district nurses and practice staff

from these 15 practices were

interviewed.

Telephone interview using semi-

structured interview guide including

questions focusing on the 7c's of GSF.

Thematic analysis was used. Using

three levels of matrices. First a matrix

for each practice, then condensed at

an area level. Finally, a comparative

matrix looking at differences between

GSF and nonm-GSF practices.

CASP 9/10

Inter-professional relationships

and communication in primary

palliative care: Impact of the

Gold Standards Framework

Mahmood-Yousuf,63 2008

United Kingdom

Qualitative interview case study

Aim: to evaluate current PC

knowledge of rural GPs And

nurses, learning needs of both and

access to PC information and

services

Setting: General practices from three

primary care trusts in England.

Participants: n= 38 GPs, district nurses,

Macmillan nurses, and framework

facilitators from 15 practices

Semi-structured interviews around

communication between

professionals about terminally ill

patients and teamwork in delivering

care.

Contacted by letter and then a follow

up phone call.

Analysis - matrix analysis - matrix cells

were populated with relevant text

from interviews.

CASP

Qualitative:

8/10





interview study

Mason,23 2013

United Kingdom

Qualitative










settings.










CASP

Qualitative:

9/10



Care of the haematology patient

and their family: the GP

viewpoint

McGrath,66 2007

Australia

Design: Qualitative

Aim: To examine the GP role in

a model of care for haematology

that extends to bereavement.

Setting: Australian medical practice

Participants: 96 health professionals

involved in the care of people with

haematological malignancy, including 2

GPs

Open ended interviews, thematic

analysis

CASP 3/10

General practitioner attitudes to

case conference: How can we

increase participation and

effectiveness?

Mitchell,68 2002

Australia

Qualitative

Aim: to exploring attitudes and

barriers to case conferencing for

GP's


metropolitan, regional and rural

Australia

Participants: 29 GPs

Exploratory semi-structured

interviews. Analysis type not

specified

CASP

Qualitative:

5/10

GP case conferences- lessons

learned.

56 Case conferences

Mitchell,69 2005

Australia

Design: Telephone interviews

Aim: To describe the utility and

acceptability to general

practitioners and palliative care

staff of case conferences in

palliative care

Design: Telephone interviews

Participants: 52 GPs who participated in

56 Case conferences

Qualitative study CASP

8/10

Do case conferences between


specialist palliative care services

improve quality of life? A

randomised controlled trial

(ISRCTN 52269003)

Mitchell,42 2008

Australia

RCT

Aim: Do case conferencing

improve QOL for palliative care?

Setting: General practice and hospital

Intervention: case conference vs usual

care

Participants: 159 palliative care patients.

A multi-centred randomised

controlled trial of specialist- GP case

conferences, with the GP

participating by teleconference, or

usual care and communication

methods.

An intention-to-treat analyses were

conducted using recruitment, and

time of death, as fixed time points.

JDAD: 3/8

.



Case conferences between


specialist teams to plan end of

life care of people with end

stage heart failure and lung

disease: an exploratory pilot

study

Mitchell,43 2014

Australia


Aim: to assess the effectiveness of

case conferences between

specialist teams and GP in

improving patient outcomes for

people with end stage heart

failure or lung disease.


Intervention: Case conference between

GP, palliative care physician and case

management nurse.

Participants: Twenty-three case

conferences involving 21 GPs were

conducted between November 2011 and

November 2012

Rates of service utilisation

(emergency department [ED]

presentations, ED discharges back to

home, hospital admissions, and

admission length of stay) before and

after case conference were calculated

NOS Cohort

4/5 (not all

elements of

assessment

relevant).


general practice: findings of a

national GP questionnaire

survey

Mitchell,47. 2016

United Kingdom



Aims: Describe-





EOLC?

Setting:





and Wales.


responses

CASP

Qualitative

8/10

Facilitating good process in

primary palliative care: Does the

Gold Standards Framework

enable quality performance?

Munday,61 2007

United Kingdom

Qualitative

Aim: to explore the effectiveness

and sustainability of the

implementation of Gold

Standards Framework at practice

level.


metropolitan, regional and rural UK

Participants: 15 practices, comprising of

45 interviews

Semi-structured interviews and

matrix analysis

NOS Cross-

sectional:

8/10



Shared care in basic level

palliative home care:

Organizational and

interpersonal challenges

Neergaard,73 2010

Denmark

Qualitative

Aim: to analyse health

professionals’ views on inter-

professional cooperation in basic

level palliative home care for

terminally ill cancer patients.

Setting: General practices

Participants: A total of 43 health

professionals (23 family physicians, 5

chief physicians, and 15 home care

nurses) were included in 7 semi-

structured group interviews.

Exploratory qualitative focus groups CASP

Qualitative:

6/10

Rural palliative care needs: a

survey of primary care

professionals in Powys, Wales.

Noble,64 2001

United Kingdom

Design: Postal survey

Aim: To assess a new, coordinated

framework for the commissioning

of specialist cancer and palliative

care services and an educational

intervention to raise the

standards of generalist palliative

care.

Setting: Geographically large, sparsely

populated county in Wales consisting

of several district communities with no

district general hospital.

Participants: GPs in Powys, Macmillan

GPCFs (general practitioner clinical

facilitator), and district nurses working as

part of primary health care based in GP

practices and charge nurses and sisters

working on community hospital wards

where palliative care is provided.

Post survey. Mixed response

type: alternatives, Likert, free text.

CASP 6/10




O’Connor,32 2006

Australia


interview.








Setting: Rural WA.





ended questions.

CASP 9/10



The role of primary care

physicians in advanced cancer

care: Perspectives of older

patients and their oncologists

O'Toole,30 2009

USA

RCT and Cross sectional

Aim: to identify age- related

differences in patient and

oncologist perspectives on

involvement of GPs

Setting: Teaching hospital-based cancer

clinics

Participants: 39 oncologists and 357

Patients who had an oncologist and PCP

enrolled 2 to 3 months after an advanced

cancer diagnosis

Survey - demographics and attitudes

to involvement of GP in ongoing care.

Patients were already part of a RCT

looking at a support intervention.

NOS Cross-

sectional:

2/10 (not all

elements of

assessment

relevant)






survey

Peng,40 2013

Taiwan

Cross sectional









care.








Structured questionnaire NOS Cross

sectional 6/9





perspective.

Phillips55 2009

Australia



perceptions and

understanding of a





Thirteen GPs


8/10

Improving generalist end of life

care: National consultation with

practitioners, commissioners,

academics, and service user

groups

Shipman,46 2008

Qualitative

Aim: to identify major concerns in

the commissioning, provision,

research and use of generalist end

of life care

Setting: Primary and secondary care,

specialist palliative care, and academic

and voluntary sectors in England and

Scotland.

Participants: Healthcare practitioners,

commissioners, academics, and

representatives of user and voluntary

Qualitative approach: a national

consultation and prioritising exercise

using a modified form of the nominal

group technique.

CASP

Qualitative:

8/10



United Kingdom groups. 74% of those invited (210/285)

participated.

End-of-life care from the

perspective of primary care

providers

Silviera,51 2012

USA

Qualitative

Aim: to explore the factors

influencing primary care

providers' ability to care for their

dying patients in Michigan

Setting: Primary care practices in

southeast Michigan.

Participants: 28 primary care

practitioners and 22 clinical support staff

from by 7 diverse primary care practices

16 focus groups to explore the

provision of end-of-life care

Interviews were analyzed using

thematic analysis.

CASP

Qualitative:

10/10

Palliative Care Partnership: a

successful model of

primary/secondary integration

Stewart,76

2006

New Zealand

Qualitative

Aim: to assess outcomes of an

integration project between GPs

and palliative care


Participants: Practices and GPS, not clear

how many were surveyed or responded.

Survey and patient record

Qualitative comments regarding

communication and linkages from a

successful model – a model of

integration that combine

participation framework, education

program, and partnership

administration and governance

group.

CASP

Qualitative:

1/10

Out-of-hours GPs and palliative

care – a qualitative study

exploring information exchange

and communication issues.

Taubert,65 2010

UK

Design: In-depth, semi-structured

interviews.

Aim: Explore factors that they

(out-of-hours GPs) identified as

detrimental or beneficial for good


themselves, patients, relatives

and other professionals,

specifically to palliative care

encounters.

Setting: GPs working with a privately

contracted out-of-hours primary care

provider in Cardiff, UK.

Participants: 9 GPs agreeing out of 60 GPs

contacted.

In-depth, semi-structured interviews. CASP 10/10

PaTz groups for primary

palliative care: reinventing

cooperation between general

practitioners and district nurses

in palliative care: an evaluation

study combining data from

Cross sectional, and qualitative

Aim: to explore experiences of

collaboration between general

practitioners and district nurses,

and perceived benefits of and

Setting: Primary care

Participants: 24 general practitioners

completed a survey questionnaire.

7 GPs, 5 district nurses and 2 PC

consultants attended focus groups.

A survey questionnaire and focus

group discussion

CASP

Qualitative:

8/10

NOS Cross-

sectional:



focus groups and a

questionnaire

van der Plas,71 2014

Netherlands

barriers for implementation of

PaTz (PC at home).

4/5 (not all

elements of

assessment

relevant).

Involvement of the practice

nurse in supporting older people

with heart failure: GP

perspectives.

Waterworth,75 2012

New Zealand

Design: In-depth, semi-

structured interviews.

Aim: Explore views of GPs

regarding involvement of practice

nurse (PN) in supporting older

people with heart failure

throughout disease trajectory.

Identify specific implications for

initiating advance care planning

and improving end-of-life care.

Setting: Urban New Zealand (Auckland).

Participants: 30 GPs from a range of GP

practices (representing

different practice demographics).

In-depth telephone interviews, semi-

structured.

CASP 8/10

3.6 Availability of GP and GPN services




Burge,21 2001

Canada

Qualitative




hospital resources.





Focus groups


Thematic analysis

CASP 8/10








Chile.

Cameron,27 2009

Chile

Design: Hermeneutic

phenomenology











palliative care.








nurse).




practice nurses.

CASP

10/10

Developing a framework for

primary palliative care services.

Daniels,58 2001

United Kingdom

Design: Mixed methods design

Aim: to evaluate current care

provision and explore methods of

developing palliative care services

in general practice.

Setting: Single urban general practice

Participants: 21 team members

associated with the general practice, 22

patients and their carers identified from

a records search.

Phase one: multiple team meetings

Phase two: questionnaires and

individual interviews with team

members to facilitate critical thinking

about palliative care service

provision.

CASP

9/10




patients


Netherlands

Cross-sectional





death.



Dutch GPs




3 months of death.

NOS Cross

Sectional

5/10













interviews.

CASP 8/10




teams.

DeMiglio,39. 2012

Canada





providers



Shared care: The barriers

encountered by community-

based palliative care teams in

Ontario, Canada

DeMiglio,72 2012

Canada

Qualitative

Aim: to explore barriers to views

and experiences of community

based palliative care teams about

facilitators and barriers to shared

care with community based

primary care teams.

Setting: community-based palliative care

Participants: five community-based

palliative care teams and six key-

informants

Thematic analysis.

Synthesis of data using a 3-I

framework,

CASP 8/10




practitioners.

Dumitrescu,77 2005

Romania













nation.


71% response rate.


Cancer Patients Use Hospital-

Based Care Until Death: A

Further Analysis of the Dutch

Bone Metastasis Study

Meeuse,54 2011

Netherlands


study) Multiple Questionnaires d

uring RCT of radiation therapy for

bony metastases

Aim: To describe health

care utilization in cancer

patients with bony metastases,

and independent predictors

for that utilisation

Setting: Dutch Oncology and community

service providers

Participants: 661/860 (77%) potential

respondents

Multilevel logistic regression. NOS Cross-

Sectional

10/10




general practice: findings of

a national GP questionnaire

survey

Mitchell,47 2016

United Kingdom



Aims: Describe-





EOLC?

Setting:





and Wales.


responses

CASP

Qualitative

8/10




Noble,64 2001

United Kingdom








care.














CASP 6/10

General practitioners’

experience of bereavement care

and their educational support

needs.

O’Connor,33 2014

Australia


interview.

Aim: to explore GPs’

understandings of bereavement

support and their educational

and professional development

needs in relation to providing

bereavement care.


Participants: 19 WA GPs (12 female)

Semi-structured interviews CASP 9/10







8/10




perspective.

Phillips,52 2009

Australia


perceptions and

understanding of a




Thirteen GPs

Attitudes and barriers to

involvement in palliative care by

Australian urban general

practitioners.

Rhee,35 2008

Australia


Aim: To determine the level of

participation of Australian urban

GPs in palliative care and to

determine the main barriers

facing them in providing this care.

Setting: Sydney, Australia. 50% of surveys

sent to lower socioeconomic (SES) areas

and 50% sent to higher SES areas of

Sydney.

Participants: 500 GPs sent surveys. 269

returned.

Cross sectional postal survey.

Questions formulated with a panel of

experts in palliative care or GPs with

special interests in palliative care.

CASP 10/10

Palliative care provision by rural

general practitioners in New

Zealand.

Smyth,78 2010

New Zealand

Design: Cross-sectional postal

survey

Aim: Ascertain the workload for

rural general practitioners

providing palliative care and to

identify barriers to care for

patients living in rural areas of

New Zealand.

Setting: Rural New Zealand.

Participants: GPs working in rural areas of

NZ. 186 responses (42.2% response rate).

Postal survey, questions adapted

from literature.

CASP 7/10





Taubert,65 2010

United Kingdom


interviews.








encounters.





contacted.




Involvement of the practice

nurse in supporting older people

with heart failure: GP

perspectives.

Waterworth,75 2012

Design: In-depth, semi-

structured interviews.

Aim: Explore views of GPs

regarding involvement of practice

nurse (PN) in supporting older

people with heart failure

throughout disease trajectory.

Identify specific implications for

initiating advance care planning

and improving end-of-life care.

Setting: Urban New Zealand (Auckland).

Participants: 30 GPs from a range of GP

practices (representing

different practice demographics).

In-depth telephone interviews, semi-

structured.

CASP 8/10

3.7 Specific circumstances




in Germany

Brueckner,49 2009

Germany

Qualitative





persons in Germany.







general nurses).


9/10




Burge,21 2001

Canada

Qualitative




hospital resources.





Focus groups


Thematic analysis

CASP 8/10








Chile.

Cameron,27 2009

Chile

Design: Hermeneutic

phenomenology











palliative care.








nurse).




practice nurses.

CASP

10/10




Dahlhaus,31 2013

Germany

Qualitative





confront








CASP 9/10

General practitioners'

perspectives on the avoidability

of hospitalizations at the end of

life


Netherlands

Sequential Mixed methods design

Aim: To explore GP views on

whether and how hospitalizations

could have been avoided in the

last 3 months of life and barriers

to avoid this.

Setting: Netherlands GPs

Participants: 319 GPs who had a non-

acute death. In-depth interviews wwith

18 GPs

National cross-sectional design, then

in depth Qualitative interviews.

NOS Cross-

sectional

4/9




practitioners.













Dumitrescu,77 2005

Romania




nation.


71% response rate.

Care of the haematology patient

and their family: the GP

viewpoint

McGrath,66 2007

Australia

Design: Qualitative

Aim: To examine the GP role in

a model of care for haematology

that extends to bereavement.

Setting: Australian medical practice

Participants: 96 health professionals

involved in the care of people with

haematological malignancy, including 2

GPs

Open ended interviews, thematic

analysis

CASP 3/10




Noble,64 2001

United Kingdom








care.














CASP 6/10




O’Connor,32 2006

Australia


interview.








Setting: Rural WA.





ended questions.

CASP 9/10







perspective.

Phillips,52 2009,

Australia



perceptions and

understanding of a





Thirteen GPs


8/10

Palliative care provision by rural

general practitioners in New

Zealand.

Smyth,78 2010

New Zealand

Design: Cross-sectional postal

survey

Aim: Ascertain the workload for

rural general practitioners

providing palliative care and to

identify barriers to care for

patients living in rural areas of

New Zealand.

Setting: Rural New Zealand.

Participants: GPs working in rural areas of

NZ. 186 responses (42.2% response rate).

Postal survey, questions adapted

from literature.

CASP 7/10

Finding common ground to

achieve a “good death”: family

physicians working with

substitute decision-makers of

dying patients. A qualitative

grounded theory study.

Tan,57 2013

Canada

Design: Qualitative

Aim: to describe Canadian family

physicians’ experiences of conflict

with substitute decision-makers

of dying patients to identify

factors that may facilitate or

hinder the end-of-life decision-

making process.

Setting: Edmonton, Canada

Participants: Purposive sample of eleven

urban GPs

Individual semi-structured

interviews, Analysis using Grounded

theory methodology.

CASP

9/10





methods study

Tan,44 2009

Australia





practice.



and rural areas)





NOS Cross-

sectional

2/5 (not all

elements of

assessment

relevant).







Taubert,65 2010

United Kingdom


interviews.








encounters.





contacted.


1 CASP: Critical Appraisal Skills Programme qualitative checklist http://media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf

2 NOS: Newcastle-Ottawa Scale Cross-sectional: This scale was adapted from the Newcastle-Ottawa Quality Assessment Scale for cohort studies by Herzog R et al , BMC

Public Health201313:154. DOI: 10.1186/1471-2458-13-154

3 NOS: Newcastle-Ottawa Scale Case-control: http://www.ohri.ca/programs/clinical_epidemiology/nos_manual.pdf

4 NOS: Newcastle-Ottawa Scale Cohort: http://www.ohri.ca/programs/clinical_epidemiology/nos_manual.pdf



Appendix 3 Details of studies references updated 3 June

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Transcript of Appendix 3 Details of studies references updated 3 June