Does persistent involvement by the GP improve palliative care at home for end-stage cancer patients?

Research output: Contribution to journalJournal articlepeer-review

Objective: To analyse the effect of GP home visits on the granting of a terminal declaration (TD) and on place of death. Participants and desig n: A total of 2025 patients with cancer as the primary cause of death in the period 1997-1998, were investigated in a mortality follow-back design using the Danish Cancer Register and four administrative registers. The Danish TD can be issued by a physician for patients with an estimated prognosis of six months or less. The TD gives the right to economic benefits and increased care for the dying patient. Setting: The island of Funen/Denmark. Main outcome measures: Main out come - hospital death. Intermediate outcome - TD. Results: A total of 38% of patients received a TD and 56% died in hospital. GP home visits in the week before TD (odds ratio (OR): 16.8; 95% CI: 8.2-34.4), as well as four weeks before TD (OR: 6.4; 95% CI: 4.5-9.2) were associated with an increased likelihood of receiving a TD. GP home visits in the group with TD (OR: 0.18; 95% CI: 0.11-0.29) and the group without TD (OR: 0.08; 95% CI: 0.05-0.13) was inversely associated with hospital death. A dose-response relationship was found in both groups. Conclusion: Persistent involvement by the GP is associated with improved end-of-life care for cancer patients. Provided that temporal relations are taken into account, the mortality follow-back design can be a suitable and ethical research method to highlight and monitor end-of-life cancer care.

Original languageEnglish
JournalPalliative Medicine
Issue number5
Pages (from-to)507-512
Number of pages6
Publication statusPublished - 2006

    Research areas

  • Cancer, GP, Mortality follow-back study, Palliative care, Place of death, Population-based

ID: 324141297