Cathrien Kager
Publicatie
Datum
25-03-2026
Palliative care in general practice for patients with cancer, organ failure and dementia or old-age: a cross-sectional study among general practitioners.
Bouritius, E.M., Bergman, T.D., Pasman, H.R.W., Kager, C.C.M., Onwuteaka-Philipsen, B.D. Palliative care in general practice for patients with cancer, organ failure and dementia or old-age: a cross-sectional study among general practitioners. BMC Primary Care: 2026.
Lees online
Background
Palliative care enhances the quality of life of patients and their relatives facing a life-threatening illness or vulnerability. Initially, curative and life-prolonging treatments may be given alongside palliative care, but as the end of life approaches, palliative care becomes more prominent. Illness trajectories vary, and a distinction is made between the illness trajectories of cancer, organ failure and dementia or old age. This study compares end-of-life care for patients who died from cancer, organ failure and dementia or old age in the Netherlands, based on general practitioners’ reports.
Methods
This retrospective cross-sectional study used questionnaires completed by general practitioners within The Dutch Sentinel General Practice Network, a network designed and managed to be representative for the Dutch population (for age, sex and population density). Patients whose death was non-sudden between 1 January 2017 and 31 December 2019 were included. Outcomes include the importance of (curative, life-prolonging and palliative) treatment aims, palliative care provision, end-of-life discussions, and advance care planning. Differences in care between illness trajectory groups (patients with cancer, organ failure and dementia/old age) were analyzed using logistic regression analyses.
Results
In the given period, general practitioners registered a total of 1364 deaths. Of these, 686 patients were included. These patients were under care of a general practitioner most of their last year of life and died non-suddenly from cancer (n = 435), organ failure (n = 128) or dementia/old-age (n = 123). As death approached, the importance of curative and life-prolonging treatment aims decreased, while importance of palliation increased, especially for patients with cancer. General practitioners provided palliative care more frequently to patients with cancer (89%) compared to those with organ failure (70%, OR 0.33) or dementia/old-age (79%, OR 0.26). End-of-life discussions were more common with patients with cancer, while one-third of patients with dementia/old age had no end-of-life discussions at all. General practitioners were more aware of the preferred place of death and end-of-life preferences of patients with cancer (92% and 76%), compared to patients with organ failure (81%, OR 0.38 and 56% OR 0.42) and dementia/old-age (87%, OR 0.38 and 50%, OR 0.25).
Conclusions
This study indicates that for patients with cancer, treatment is more often aimed at palliation, general practitioners more frequently provide palliative care, and end-of-life topics and advance care planning are discussed more often, compared to patients with organ failure or dementia/old-age. However, patients may have palliative care needs regardless of their illness or life expectancy. Therefore, it is important that palliative care is initiated early in the illness trajectory.
Palliative care enhances the quality of life of patients and their relatives facing a life-threatening illness or vulnerability. Initially, curative and life-prolonging treatments may be given alongside palliative care, but as the end of life approaches, palliative care becomes more prominent. Illness trajectories vary, and a distinction is made between the illness trajectories of cancer, organ failure and dementia or old age. This study compares end-of-life care for patients who died from cancer, organ failure and dementia or old age in the Netherlands, based on general practitioners’ reports.
Methods
This retrospective cross-sectional study used questionnaires completed by general practitioners within The Dutch Sentinel General Practice Network, a network designed and managed to be representative for the Dutch population (for age, sex and population density). Patients whose death was non-sudden between 1 January 2017 and 31 December 2019 were included. Outcomes include the importance of (curative, life-prolonging and palliative) treatment aims, palliative care provision, end-of-life discussions, and advance care planning. Differences in care between illness trajectory groups (patients with cancer, organ failure and dementia/old age) were analyzed using logistic regression analyses.
Results
In the given period, general practitioners registered a total of 1364 deaths. Of these, 686 patients were included. These patients were under care of a general practitioner most of their last year of life and died non-suddenly from cancer (n = 435), organ failure (n = 128) or dementia/old-age (n = 123). As death approached, the importance of curative and life-prolonging treatment aims decreased, while importance of palliation increased, especially for patients with cancer. General practitioners provided palliative care more frequently to patients with cancer (89%) compared to those with organ failure (70%, OR 0.33) or dementia/old-age (79%, OR 0.26). End-of-life discussions were more common with patients with cancer, while one-third of patients with dementia/old age had no end-of-life discussions at all. General practitioners were more aware of the preferred place of death and end-of-life preferences of patients with cancer (92% and 76%), compared to patients with organ failure (81%, OR 0.38 and 56% OR 0.42) and dementia/old-age (87%, OR 0.38 and 50%, OR 0.25).
Conclusions
This study indicates that for patients with cancer, treatment is more often aimed at palliation, general practitioners more frequently provide palliative care, and end-of-life topics and advance care planning are discussed more often, compared to patients with organ failure or dementia/old-age. However, patients may have palliative care needs regardless of their illness or life expectancy. Therefore, it is important that palliative care is initiated early in the illness trajectory.
Background
Palliative care enhances the quality of life of patients and their relatives facing a life-threatening illness or vulnerability. Initially, curative and life-prolonging treatments may be given alongside palliative care, but as the end of life approaches, palliative care becomes more prominent. Illness trajectories vary, and a distinction is made between the illness trajectories of cancer, organ failure and dementia or old age. This study compares end-of-life care for patients who died from cancer, organ failure and dementia or old age in the Netherlands, based on general practitioners’ reports.
Methods
This retrospective cross-sectional study used questionnaires completed by general practitioners within The Dutch Sentinel General Practice Network, a network designed and managed to be representative for the Dutch population (for age, sex and population density). Patients whose death was non-sudden between 1 January 2017 and 31 December 2019 were included. Outcomes include the importance of (curative, life-prolonging and palliative) treatment aims, palliative care provision, end-of-life discussions, and advance care planning. Differences in care between illness trajectory groups (patients with cancer, organ failure and dementia/old age) were analyzed using logistic regression analyses.
Results
In the given period, general practitioners registered a total of 1364 deaths. Of these, 686 patients were included. These patients were under care of a general practitioner most of their last year of life and died non-suddenly from cancer (n = 435), organ failure (n = 128) or dementia/old-age (n = 123). As death approached, the importance of curative and life-prolonging treatment aims decreased, while importance of palliation increased, especially for patients with cancer. General practitioners provided palliative care more frequently to patients with cancer (89%) compared to those with organ failure (70%, OR 0.33) or dementia/old-age (79%, OR 0.26). End-of-life discussions were more common with patients with cancer, while one-third of patients with dementia/old age had no end-of-life discussions at all. General practitioners were more aware of the preferred place of death and end-of-life preferences of patients with cancer (92% and 76%), compared to patients with organ failure (81%, OR 0.38 and 56% OR 0.42) and dementia/old-age (87%, OR 0.38 and 50%, OR 0.25).
Conclusions
This study indicates that for patients with cancer, treatment is more often aimed at palliation, general practitioners more frequently provide palliative care, and end-of-life topics and advance care planning are discussed more often, compared to patients with organ failure or dementia/old-age. However, patients may have palliative care needs regardless of their illness or life expectancy. Therefore, it is important that palliative care is initiated early in the illness trajectory.
Palliative care enhances the quality of life of patients and their relatives facing a life-threatening illness or vulnerability. Initially, curative and life-prolonging treatments may be given alongside palliative care, but as the end of life approaches, palliative care becomes more prominent. Illness trajectories vary, and a distinction is made between the illness trajectories of cancer, organ failure and dementia or old age. This study compares end-of-life care for patients who died from cancer, organ failure and dementia or old age in the Netherlands, based on general practitioners’ reports.
Methods
This retrospective cross-sectional study used questionnaires completed by general practitioners within The Dutch Sentinel General Practice Network, a network designed and managed to be representative for the Dutch population (for age, sex and population density). Patients whose death was non-sudden between 1 January 2017 and 31 December 2019 were included. Outcomes include the importance of (curative, life-prolonging and palliative) treatment aims, palliative care provision, end-of-life discussions, and advance care planning. Differences in care between illness trajectory groups (patients with cancer, organ failure and dementia/old age) were analyzed using logistic regression analyses.
Results
In the given period, general practitioners registered a total of 1364 deaths. Of these, 686 patients were included. These patients were under care of a general practitioner most of their last year of life and died non-suddenly from cancer (n = 435), organ failure (n = 128) or dementia/old-age (n = 123). As death approached, the importance of curative and life-prolonging treatment aims decreased, while importance of palliation increased, especially for patients with cancer. General practitioners provided palliative care more frequently to patients with cancer (89%) compared to those with organ failure (70%, OR 0.33) or dementia/old-age (79%, OR 0.26). End-of-life discussions were more common with patients with cancer, while one-third of patients with dementia/old age had no end-of-life discussions at all. General practitioners were more aware of the preferred place of death and end-of-life preferences of patients with cancer (92% and 76%), compared to patients with organ failure (81%, OR 0.38 and 56% OR 0.42) and dementia/old-age (87%, OR 0.38 and 50%, OR 0.25).
Conclusions
This study indicates that for patients with cancer, treatment is more often aimed at palliation, general practitioners more frequently provide palliative care, and end-of-life topics and advance care planning are discussed more often, compared to patients with organ failure or dementia/old-age. However, patients may have palliative care needs regardless of their illness or life expectancy. Therefore, it is important that palliative care is initiated early in the illness trajectory.
Gegevensverzameling