ArticlePloS one2014
Barriers to advance care planning in cancer, heart failure and dementia patients: a focus group study on general practitioners' views and experiences.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
82 citing papers in PubMed, 7 syntheses or guidelines pooled it, 212 citations in OpenAlex.
- Factors associated with participation in advance care planning among people with different degrees of cognitive impairment: a systematic review.BMC palliative care · 2026Pooled it
- What helps or hinders the communication of poor prognosis between secondary and primary care? A systematic review with narrative synthesis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Pooled it
- Experiences and perspectives of healthcare professionals implementing advance care planning for people suffering from life-limiting illness: a systematic review and meta-synthesis of qualitative studies.BMC palliative care · 2023Pooled it
- Increasing the chance of dying at home: roles, tasks and approaches of general practitioners enabling palliative care: a systematic review of qualitative literature.BMC primary care · 2023Pooled it
- Advance care planning for adults with heart failure.The Cochrane database of systematic reviews · 2020Pooled it
- Barriers and facilitators for GPs in dementia advance care planning: A systematic integrative review.PloS one · 2018Pooled it
- Barriers to advance care planning at the end of life: an explanatory systematic review of implementation studies.PloS one · 2015Pooled it
- Complex advance care planning intervention in general practice (ACP-GP): a cluster-randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Trial
- Adding a second surprise question triggers general practitioners to increase the thoroughness of palliative care planning: results of a pilot RCT with cage vignettes.BMC palliative care · 2018Trial
- Approaching Serious Illness Conversations in Amyotrophic Lateral Sclerosis Using Telehealth: A Practical Guide.Neurology. Clinical practice · 2026Review
- Factors influencing readiness for advance care planning in dementia: a qualitative interview study.BMC palliative care · 2026Article
- Geriatricians' perceptions on multidisciplinary heart failure care in Belgium an exploratory qualitative study.BMC health services research · 2026Article
- Patient- and Caregiver-Identified Goals for Advance Care Planning in Patients With Dementia or Cognitive Impairment.Dementia (London, England) · 2026Article
- Artificial intelligence-based approaches for advance care planning: a scoping review.BMC palliative care · 2025Article
- Article
- "You like to be in control of your own destiny to a degree, don't you?": conscientious autonomy and planning for future care with dementia.BMC palliative care · 2025Article
- Food for Thought: Papas Fritas.Journal of the American Geriatrics Society · 2025Article
- Experiences of using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) in English general practice: a qualitative study among key primary health and social care professionals, patients, and their relatives.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Article
- Physician-Related Gaps in Hospice Referral for Patients with Advanced Dementia.Clinical interventions in aging · 2025Article
22 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe long-term and often lifelong relationship of general practitioners (GPs) with their patients is considered to make them the ideal initiators of advance care planning (ACP). However, in general the incidence of ACP discussions is low and ACP seems to occur more often for cancer patients than for those with dementia or heart failure.
objectiveTo identify the barriers, from GPs' perspective, to initiating ACP and to gain insight into any differences in barriers between the trajectories of patients with cancer, heart failure and dementia.
methodFive focus groups were held with GPs (n = 36) in Flanders, Belgium. The focus group discussions were transcribed verbatim and analyzed using the method of constant comparative analysis.
resultsTHREE TYPES OF BARRIERS WERE DISTINGUISHED: barriers relating to the GP, to the patient and family and to the health care system. In cancer patients, a GP's lack of knowledge about treatment options and the lack of structural collaboration between the GP and specialist were expressed as barriers. Barriers that occured more often with heart failure and dementia were the lack of GP familiarity with the terminal phase, the lack of key moments to initiate ACP, the patient's lack of awareness of their diagnosis and prognosis and the fact that patients did not often initiate such discussions themselves. The future lack of decision-making capacity of dementia patients was reported by the GPs as a specific barrier for the initiation of ACP.
conclusionThe results of our study contribute to a better understanding of the factors hindering GPs in initiating ACP. Multiple barriers need to be overcome, of which many can be addressed through the development of practical guidelines and educational interventions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.