Recruiting general practitioners for palliative care research in primary care: real-life barriers explained

B Leysen,B Van Den Eynden,J Wens,A Janssens

doi:10.1186/s12875-019-0930-y

B Leysen, B Van Den Eynden + Show 2 more

Open Access

https://doi.org/10.1186/s12875-019-0930-y

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Abstract

BackgroundThe implementation of early palliative care within a primary care setting is a recent academic topic. Recruiting General Practitioners (GPs) to participate in a palliative care study can be challenging. The pro-Spinoza project implemented a Care Pathway for Primary Palliative Care in 5 areas in Belgium. During this project, the feasibility of the recruitment of GPs and palliative care patients was evaluated.MethodsThe recruitment process was recorded in detail via an electronic logbook combining quantitative and qualitative data. Quantitative recordings included the contact types and the number of contacts with eligible GPs and were analysed descriptively. Qualitative recordings included field notes with feedback from the GPs and other stakeholders and were thematically analysed starting from the Grol and Wensing framework for professional behaviour change.ResultsOf 4065 eligible GPs working in 5 areas under research, 787 GPs (19%) were contacted individually, 398 GPs (9,8%) were contacted face-to-face and most of these 398 GPs showed high interest in the topic. 112 GPs (2,8%) signed the collaboration agreement, but finally only 65 GPs (1,6%) delivered at least a completed baseline-questionnaire. Despite the initial interest in participating, the unpredictable and busy daily workloads of the GPs, as well as inexperience with research protocols, impeded the ability of the GPs to fully engage in the study. This resulted in the high dropout rate. Participating GPs reported that they had underestimated the effort required to effectively participate in the project.ConclusionsRecruitment of GPs to palliative care research is challenging. Primary care is a vital service to engage in palliative care research however the practical limitations reduce the ability of the service to effectively engage in the research. More research is needed to determine how GPs might be better supported in research.Trial registrationClinicalTrials.gov, NCT02266069, Registered 16th October 2014, retrospectively registered.

Highlights

The implementation of early palliative care within a primary care setting is a recent academic topic
Primary care is a vital service to engage in palliative care research the practical limitations reduce the ability of the service to effectively engage in the research
More research is needed to determine how General Practitioner (GP) might be better supported in research

Summary

Introduction

The implementation of early palliative care within a primary care setting is a recent academic topic. Creating sustainable models for palliative care is a difficult task, for which in a few countries pioneers have tried to pave the path [10, 11] One of these pioneering projects was the Pro-Spinoza project [12], sponsored by the Belgian National Institute for Health and Disability Insurance (NIHDI), which aimed to evaluate the implementation of a Care Pathway for Primary Palliative Care (CPPPC) in five areas in Belgium: two Dutch-speaking areas (1 and 4), two French-speaking areas (2 and 5) and a bilingual area 3. These five areas were delineated by the working territories of collaborating palliative care networks (PCNs). Within these networks a palliative home care team (PHCT) is designed to offer concrete help and advice to primary care professionals when they are confronted with complex palliative care situations

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