Consult-GP v1.0
Research type
Research Study
Full title
Advance care planning in dementia: Improving GP consultations and development of a support programme for general practitioners
IRAS ID
322995
Contact name
Emily Spencer
Contact email
Sponsor organisation
UCLH/UCL Joint Research Office
Clinicaltrials.gov Identifier
Z6364106/2023/07/12 health research, UCL Data Protection
Duration of Study in the UK
2 years, 8 months, 1 days
Research summary
Background: People with dementia and carers report a lack of conversations about end-of-life care (EOLC) and later stages of dementia, with limited advance care planning (ACP). ACP is a process that enables individuals to define, record and review preferences for future treatment and care. Planning is important as it may improve end-of-life care, ensure the individual’s preferences are known and adhered to, and minimise the guilt and grief carers may experience. Many GPs lack confidence to approach conversations around EOLC and ACP. Previous research into ACP in dementia has focussed on the ‘what’, e.g., defining topics, themes or documents used to record outcomes. Less emphasis has been placed on the ‘how’, including how to initiate conversations and communicate empathetically.
Aims: The aim of this study is to understand how ACP and conversations around the later stages of dementia and end-of-life occur in consultations between GPs, people with dementia and carers. Based on these findings, we will develop a support package for GPs on how to conduct ACP.
Methods: This project will consist of two studies. An observational study will involve video recording annual dementia review and care planning consultations between GPs, people with dementia and their carers. We will examine consultations for discussion of ACP, conversations about later stages of dementia and EOLC as well as missed opportunities for these conversations. Recordings will be analysed using conversation analysis. Findings from the observational study will be used to co-design a support package for GPs. The co-design study will include people with dementia, current and former carers, and health and social care professionals.
Outcomes: This project will result in a package designed to support GPs deliver ACP. This has the potential to improve the number and quality of conversations taking place, supporting the provision of patient-centred EOLC.
REC name
Wales REC 4
REC reference
23/WA/0238
Date of REC Opinion
20 Sep 2023
REC opinion
Further Information Favourable Opinion