PROFESSIONAL CareSearch Online palliative care information for GPs Christine Sanderson Jennifer Tieman Background General practitioners have always been involved in providing palliative care. As Australia’s population ages, the number of patients living with cancer and end stage chronic disease will increase. Objective This article looks at existing barriers to, and community expectations of, GP involvement in the provision of palliative care. It presents the CareSearch project as one initiative aimed at building GPs’ awareness and skills in palliative care. Discussion Palliative care is traditionally viewed as being the intense care of a patient who is close to death. In recent years, the scope of palliative care has expanded to include patients who may live for many years with end stage organ failure or cancer. Care of these patients in the community inevitably involves input from the GP. Barriers to GPs’ participation in palliative care include knowledge barriers and structural factors. Some GPs feel unprepared to deal with what they see as the complex clinical and psychosocial aspects of palliative care. A number of initiatives have been developed to build the awareness and skills of GPs in palliative care. The GP section of the CareSearch website has been specifically developed to provide knowledge, skills and practical advice for GPs who provide palliative care in the community. Keywords: palliative care; education, distance; internet; education, medical, continuing/methods General practitioners play an essential role in providing palliative care and many find the area satisfying and rewarding. However, some avoid it because they believe palliative care involves stressful consultations, frequent home visits and managing difficult symptoms. Some GPs are unfamiliar with what they see as the complex clinical and psychosocial aspects of palliative care and feel unprepared to deal with them. 1,2 Australian GPs report that they see an average of three palliative care patients per year. 3 The image most closely associated with traditional palliative care is that of the intense care of a patient who is close to death. 4 However, the scope of palliative care is changing. In recent years, the palliative care needs of patients with end stage organ failure have been recognised; 5,6 this is a population that already makes up a large proportion of the caseload of many GPs. In addition, the care of common cancers such as breast, colorectal, prostate, and lung cancer has improved to the extent that GPs are increasingly involved in the ongoing management of these patients in the community. 7 Palliative care in the 21st century involves assessment and management skills that can be applied to improve the quality of life of all patients with advanced diseases and palliative care needs. Barriers to GP involvement in palliative care Barriers to GPs’ participation in palliative care have been previously identified and include knowledge barriers and structural factors. 8 Knowledge barriers occur because of small and sporadic caseloads, the rapidly expanding palliative care knowledge base, 8,9 and difficulties in accessing training and education. 10 Structural factors include demographic changes in the general practice workforce, remuneration factors, uneven distribution, and limited availability of GPs in some areas, and an increasing reluctance to conduct home visits. 8 A recent study of GPs in Sydney 2 New South Wales revealed that 25% of surveyed GPs were not involved in providing palliative care. Reasons given for noninvolvement included lack of interest and knowledge, the need for home visits, and problems with after hours care due to family and personal commitments. Some Reprinted from AUSTRALIAN FAMILY PHYSICIAN VOL. 39, NO. 5, MAY 2010 341