Dr Raechel Damarell
Senior Research Fellow, CareSearch Project, Flinders University
General practitioners (GPs) play a vital role in providing care for most people with life-limiting illnesses in the years, months, and days leading up to their death. [1] This is especially true for GPs in rural and remote areas with limited access to specialist palliative care services. [2] In these settings, rural GPs are often responsible for the continuous care of older patients as they transition between home, residential aged care, and rural hospitals. [1] For individuals who wish to die at home, whether in their own residence or within an aged care facility, a GP can facilitate this by ensuring effective symptom control and educating carers on how to keep the person comfortable as the end-of-life approaches.
A significant proportion of people die an expected death each year due to chronic conditions such as heart disease, dementia, and chronic obstructive pulmonary disease [3] – conditions that frequently do not meet the criteria for specialist palliative care services. The proportion is expected to rise as the population ages, with increasing numbers of Australians living with one or more life-limiting illnesses requiring long-term symptom management from their GP. [4]
However, GPs face challenges in providing and coordinating palliative care. These include the daily time pressures of general practice, lack of confidence in the evidence base, and the fragmented nature of our health and social care systems, often complicating cross-sector and interprofessional communication. [5] Under the current model of general practice, providing palliative care requires proactive planning and assessments to identify changing needs, initiate advance care planning discussions, and support families and informal carers. [6]
To assist GPs in their clinical decision-making and proactive care planning, CareSearch recently released its CareSearchgp app. Developed with GPs, this freely accessible, evidence-based resource supports key clinical processes across the end-of-life care trajectory, including advance care planning, case conferencing, and developing a terminal care management plan. The app provides clear guidance on symptom management, terminal prescribing, and post-death support for the bereaved. Interactive features allow GPs to curate their own library of links to useful resources or send individual information from within the app to specific patients or carers. For GPs supporting people to die at home, there is a Home Death Checklist—a tool for identifying potential issues that should be addressed ahead of time.
With their broad scope of practice, rural GPs and nurse practitioners may find the app of particular interest and value. Early career GPs can also trust in the reliability of its evidence-based content as they build their clinical skills and confidence in end-of-life care. The CareSearch website has more information about the app and links to download from the Apple or Google Play Store. Additionally, GPs can find more guidance on MBS remuneration when delivering a planned palliative care pathway in the community and residential aged care settings by visiting CareSearch's Primary Health Care Hub.
*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.