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Cited by 209Palliative Care and End-of-Life IssuesPatient-Provider Communication in HealthcarePalliative and Oncologic Care

The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.

Barriers to advance care planning in cancer, heart failure and dementia patients: a focus group study on general practitioners’ views and experiences.

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De Vleminck, Aline, Pardon, Koen, Beernaert, Kim, Deschepper, Reginald, Houttekier, Dirk, Van Audenhove, Chantal, Deliens, Luc, Vander Stichele, Robert·2014·PLoS ONE
DOI 10.1371/journal.pone.0084905PMC PMC3897376
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Abstract

BACKGROUND: The long-term and often lifelong relationship of general practitioners (GPs) with their patients is considered to make them the ideal initiators of advance care planning (ACP). However, in general the incidence of ACP discussions is low and ACP seems to occur more often for cancer patients than for those with dementia or heart failure. OBJECTIVE: To identify the barriers, from GPs' perspective, to initiating ACP and to gain insight into any differences in barriers between the trajectories of patients with cancer, heart failure and dementia. METHOD: Five focus groups were held with GPs (n = 36) in Flanders, Belgium. The focus group discussions were transcribed verbatim and analyzed using the method of constant comparative analysis. RESULTS: THREE TYPES OF BARRIERS WERE DISTINGUISHED: barriers relating to the GP, to the patient and family and to the health care system. In cancer patients, a GP's lack of knowledge about treatment options and the lack of structural collaboration between the GP and specialist were expressed as barriers. Barriers that occured more often with heart failure and dementia were the lack of GP familiarity with the terminal phase, the lack of key moments to initiate ACP, the patient's lack of awareness of their diagnosis and prognosis and the fact that patients did not often initiate such discussions themselves. The future lack of decision-making capacity of dementia patients was reported by the GPs as a specific barrier for the initiation of ACP. CONCLUSION: The results of our study contribute to a better understanding of the factors hindering GPs in initiating ACP. Multiple barriers need to be overcome, of which many can be addressed through the development of practical guidelines and educational interventions.

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Figure 1 Topic guide of the focus groups with general practitioners.
Figure 1 Topic guide of the focus groups with general practitioners.CC BY · PubMed Central

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Metadata

Authors
De Vleminck, A., Pardon, K., Beernaert, K., Deschepper, R., Houttekier, D., Van Audenhove, C., Deliens, L., & Vander Stichele, R.
Affiliations
Vrije Universiteit Brussel (BE)
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2014-01-21
Volume
9
Issue
1
Pages
e84905
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0084905
PMC
PMC3897376
OpenAlex
W2070638367
Cited by
209
References
42
Citations by year
2026: 8 · 2025: 12 · 2024: 21 · 2023: 12 · 2022: 24 · 2021: 30 · 2020: 21 · 2019: 24 · 2018: 22 · 2017: 6 · 2016: 17 · 2015: 9 · 2014: 3
FWCI
11.61
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
  • Lirias (KU Leuven) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • Vrije Universiteit Amsterdam
  • Agentschap voor Innovatie door Wetenschap en Technologie (100036)
  • Vlaamse regering
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
advance care planning, barriers to advance care planning, general practitioners, cancer patients, heart failure, dementia, GP-patient relationship, terminal phase, decision-making capacity, prognosis awareness, end-of-life care
MeSH terms
Adult, Aged, Attitude of Health Personnel, Belgium, Dementia, Female, Heart Failure, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Neoplasms, Physician-Patient Relations, Practice Patterns, Physicians', Focus Groups, Guidelines as Topic, Advance Care Planning, General Practitioners

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