[End of life care in general practice: results of an observational survey with general practitioners]. / Hausärztliche Versorgung am Lebensende (HAVEL): Ergebnisse einer retrospektiven Beobachtungsstudie.

BACKGROUND: Little is known about the amount of end of life care provided by general practitioners (GPs) in Germany. Therefore the aim of the HAVEL study is to describe the involvement of GPs in end of life care in more detail. METHODS: Data from all patients who died from natural causes within a period of 12 months (n = 452) were collected from 30 general practices with a self-developed questionnaire and compared to data from patients who died in hospice or palliative care units. RESULTS: Contact rates with GPs increased at the end of life and approximately half of the patients (48 %) were seen within 48 h prior to death. A different spectrum of diseases and symptoms were observed compared to hospice and palliative care units with predominantly chronic diseases (e.g. cardiovascular and mental diseases). DISCUSSION AND CONCLUSIONS: General practitioners are highly involved in palliative health care, even for patients who eventually die in hospitals. Differences in patient characteristics and circumstances compared to specialized palliative care should be reflected in curricula for training in palliative care and the definition of a palliative situation.

[Experiences and attitudes regarding practice-based clinical trials: results of a survey among German primary care physicians]. / Erfahrungen und Einstellungen zu Klinischen Studien in der Hausarztpraxis: Ergebnisse einer Befragung von deutschen Hausärzten.

OBJECTIVE: Clinical trials are regarded as complex due to the high demands on quality and patient safety and are still exceptional in German primary care. To optimise future trial planning, this study aimed at investigating the barriers and enablers experienced by primary care physicians (PCPs) for trial participation. METHODS: PCPs were surveyed on 11 regional primary care medical education (CME) events using a standardised questionnaire. Regression analyses were used to identify predictors for future trial participation. RESULTS: Of 804 invited PCPs, 408 (50.7%) participated in the survey (51 ± 9 years, female 35%). 69% of participants could imagine their participation in a clinical trial. Of 12 potential factors assessed, the final model retained the 2 predictors (OR; CI; P-value) "research questions relevant to practice" (2.25; 1.61-3.14;<0.001) and "new challenges/change from everyday life" (2.24; 1.67-2.97;<0.001). While 58% of participants were principally willing to participate in investigator training courses according to Good Clinical Practice (GCP), only 6% had participated in such training at the time of answering. Short events were preferred. Only 7% were willing to take over at least half of the costs of these courses. CONCLUSION: To enhance German PCPs motivation to participate in clinical trials, both trials and training courses should be tailored to the needs in the primary care setting.