Palliative Care Knowledge among German Family Physicians – a Nationwide Survey

DOI: 10.3238/zfa.2019.0267-0273

german translation / full article

Andreas Ammer, Klaus Linde, Gian Domenico Borasio, Antonius Schneider

Keywords: end-of-life-care fluid substitution palliative care vignettes

Background: Family physicians (FPs) play an essential role in the care of terminally ill patients. Studies from other countries show that FPs sometimes have significant deficits in the knowledge of basic palliative care. Until now, there has been no nationwide survey about the knowledge of German FPs in palliative care. Methods: A four-page questionnaire was sent to 1600 randomly selected FPs. An oncological case vignette and a geriatric case vignette were used to query treatment decisions in pharmacological relief of pain and respiratory distress, artificial fluid supplementation or nutrition, and hospitalization in the dying phase. Results: A total of 685 of 1471 properly delivered questionnaires were evaluated (response rate 47 %). Regarding end-of-life care, the responses showed no serious knowledge gaps among the topics covered (88 % correctly answered questions). Incorrect answers were mostly given in response to questions about (subcutaneous) fluid substitution. The additional qualification in palliative care (Zusatzbezeichnung Palliativmedizin) and a basic course palliative care (Basiskurs Palliativmedizin) had similarly positive influences on the number of correct answers (univariate regression analysis in both cases β= 0.14). Questions in the geriatric vignette were more often answered correctly than those in the oncological case vignette. Conclusions: German GPs have a good level of basic knowledge regarding the topics covered, but in questions about liquid substitution they gave some incorrect answers. Future palliative care education and training programs should place additional emphasis on geriatric cases, because the respondents‘ treatment decisions were less aligned with current standards of care in the geriatric vignette than in the oncological vignette.

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