SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2025
Equitable inclusion of patients with cancer on the palliative care register: a systematic review in primary care.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGPs are instrumental to palliative care in the UK and most practices maintain a register of patients with palliative care needs. However, many people with incurable cancer who could benefit from palliative care are not included on this register, making this a potential source of end-of-life inequity.
aimTo identify barriers and facilitators to recognising the palliative care needs of patients with cancer in the UK and understand how these factors may have an impact on those vulnerable to end-of-life inequity. DESIGN AND
settingA mixed-methods systematic review.
methodEight electronic databases (Alternative Medicine, CINAHL, Embase, Medline, PsycINFO, Scopus, SocINDEX, and Web of Science) and two preprint servers (medRXiv and Open Science Framework) were searched in November 2024. Qualitative, quantitative, and mixed-methods studies were included. Narrative synthesis was used to integrate study findings, with resulting barriers and facilitators mapped onto the COM-B model domains of capablity, opportunity, and motivation. The impact on equity was evaluated using the PROGRESS-Plus framework.
resultsSearches returned 7190 citations, with 24 studies included in the review. Seven themes were identified, with barriers and facilitators mapped onto COM-B domains: conceptualisation of palliative care; navigating challenging conversations; healthcare organisation; patient help-seeking; time and resource constraints; perceptions shaping practice; and cognitive associations. There was insufficient evidence about the barriers and facilitators that may be having an impact on those vulnerable to end-of-life inequities.
conclusionGPs experience many barriers to recognising palliative care needs. There is a need for greater understanding of the extent and nature of inequities in recognising such needs, to ensure strategies to increase recognition do not widen inequities.
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