A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries

Background: An Advance Care Plan (ACP) is a decision-making process concerning end-of-life care that embodies a patient’s values and preferences, for a time when patients are unable to make such choices on their own. ACPs have been employed into medical practices worldwide; however, they remain lar...

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Main Authors: Karendeep Somal, Tony Foley
Format: Article
Language:English
Published: University Library System, University of Pittsburgh 2021-06-01
Series:International Journal of Medical Students
Subjects:
Online Access:https://ijms.info/IJMS/article/view/567
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author Karendeep Somal
Tony Foley
author_facet Karendeep Somal
Tony Foley
author_sort Karendeep Somal
collection DOAJ
description Background: An Advance Care Plan (ACP) is a decision-making process concerning end-of-life care that embodies a patient’s values and preferences, for a time when patients are unable to make such choices on their own. ACPs have been employed into medical practices worldwide; however, they remain largely uncompleted by general practitioners (GPs), regardless of their benefits to patients and their families with respect to end of life (EOL) care. Furthermore, ACPs will soon be implemented into clinician practices across Ireland, as part of the Assisted Decision Making (Capacity) Act 2015. This review aims to explore the literature to examine challenges GPs may face in employing ACPs into clinical practice. Methods: An electronic search was performed through three databases: PubMed, MEDLINE, and CINAHL Plus, through which a total of eleven studies met the selection criteria. Additionally, three studies were provided by experts in the field. Thus, a total of fourteen studies were condensed and critically appraised through CASP (Critical Appraisal Skills Program), which concluded that the quality of the studies was high. Conclusion: Through this review, knowledge gaps and barriers for GPs regarding ACPs were identified. Barriers for implementing ACPs into practice were categorized into three major themes: barriers for the GPs, barriers in the healthcare system, and barriers regarding the patient. These included insufficient time, complexity of the ACP documents themselves, uncertainty of the disease prognosis, and the ultimate fear of inducing anxiety and loss of hope in patients.
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spelling doaj.art-8a6230c196a1449ca393b449a47882832023-09-02T16:13:32ZengUniversity Library System, University of PittsburghInternational Journal of Medical Students2076-63272021-06-019210.5195/ijms.2021.567A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other CountriesKarendeep Somal0Tony Foley1Graduate Entry Medicine, University College Cork, IrelandUniversity College Cork, Department of General Practice, Ireland Background: An Advance Care Plan (ACP) is a decision-making process concerning end-of-life care that embodies a patient’s values and preferences, for a time when patients are unable to make such choices on their own. ACPs have been employed into medical practices worldwide; however, they remain largely uncompleted by general practitioners (GPs), regardless of their benefits to patients and their families with respect to end of life (EOL) care. Furthermore, ACPs will soon be implemented into clinician practices across Ireland, as part of the Assisted Decision Making (Capacity) Act 2015. This review aims to explore the literature to examine challenges GPs may face in employing ACPs into clinical practice. Methods: An electronic search was performed through three databases: PubMed, MEDLINE, and CINAHL Plus, through which a total of eleven studies met the selection criteria. Additionally, three studies were provided by experts in the field. Thus, a total of fourteen studies were condensed and critically appraised through CASP (Critical Appraisal Skills Program), which concluded that the quality of the studies was high. Conclusion: Through this review, knowledge gaps and barriers for GPs regarding ACPs were identified. Barriers for implementing ACPs into practice were categorized into three major themes: barriers for the GPs, barriers in the healthcare system, and barriers regarding the patient. These included insufficient time, complexity of the ACP documents themselves, uncertainty of the disease prognosis, and the ultimate fear of inducing anxiety and loss of hope in patients. https://ijms.info/IJMS/article/view/567General PractitionersGeneral practiceAdvance care planningAdvance careEnd of life careTerminal care
spellingShingle Karendeep Somal
Tony Foley
A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries
International Journal of Medical Students
General Practitioners
General practice
Advance care planning
Advance care
End of life care
Terminal care
title A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries
title_full A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries
title_fullStr A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries
title_full_unstemmed A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries
title_short A Literature Review of Possible Barriers and Knowledge Gaps of General Practitioners in Implementing Advance Care Planning in Ireland: Experience from Other Countries
title_sort literature review of possible barriers and knowledge gaps of general practitioners in implementing advance care planning in ireland experience from other countries
topic General Practitioners
General practice
Advance care planning
Advance care
End of life care
Terminal care
url https://ijms.info/IJMS/article/view/567
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