Barriers and Facilitators of Family Meetings in Primary Palliative Care: Insights From Slovenia.

Background: Within palliative care, family meetings are recognised as the most effective practice for placing the patient and their family at the centre of care, thereby ensuring quality palliative care. The aim of this study was to determine how these meetings are conducted in primary healthcare and to identify the factors influencing them. Methods: Sixteen semi-structured interviews were conducted with family physicians (FP) in Slovenia, who were expressly, and using the snowball method, invited to participate in the study. Transcripts were analysed using the principles of thematic analysis. Results: It was found that participating FPs frequently discuss diseases, treatment, expectations and goals with patients and families. However, these discussions are seldom structured and fully conducted according to family meeting guidelines, primarily due to time constraints. Barriers to conducting family meetings include patient and family reluctance, the staff's lack of palliative care knowledge, time, and financial challenges. Positive factors include a good doctor-patient-family relationship, an exact diagnosis, the doctor's experience and competence, additional palliative care training and the presence of other team members. Conclusion: Our research provides a unique insight into the implementation of family meetings at the primary level in Slovenia. FPs recognise numerous benefits of family meetings and consider them meaningful and time efficient. They emphasise that open discussions with the patient and their family are crucial for quality palliative care at the primary level. Considering simpler models of family meetings for the primary level appears sensible. Further research is needed to assess the cost-benefit relationship of family meetings.