O-116 How do general practitioners conceptualise advance care planning in their practice? A qualitative study

Abstract

Background Although general practitioners (GPs) are well placed to initiate advance care planning (ACP) in a timely manner, many find it difficult. Training programmes can improve their skills in performing this task but need to draw on GPs’ previous knowledge and experience to be effective. Aim To explore how GPs conceptualise ACP, based on their experiences with ACP in their practice. Methods This study, using a qualitative study design, was conducted with GPs in Belgium. Five focus groups were held with 36 GPs. Discussions were analysed using a constant comparative method. Results With regard to content of discussions, ACP was conceptualised as the organisation of professional care required to meet patients’ needs, bad news conversations, choices of treatment and types of care for the patient, and the completion of documents. With regard to tasks for the GP, ACP was considered in terms of exploring patients’ vague preferences, coordinating care to address patients’ and families’ needs, actively initiating ACP and providing comfort when discussing palliative care with terminal patients. These conceptualisations could occur simultaneously in the narrative of a GP, however some only used one of the conceptualisations to present ACP. Discussion This study illustrates that GPs have varying conceptualisations of ACP, of which some are more limited to specific aspects of ACP. Conclusion Training efforts building further on GPs’ conceptualisation of ACP could improve their skills and knowledge of the ACP process, and lead to a better uptake of all the important elements of ACP discussions.