OP-41 Delivering end-of-life care in residential aged care facilities – how can GPs work alongside specialist palliative medicine providers to optimise care delivery?

<h3>Background</h3> Australia has an ageing population. Older Australians frequently require medical services in their later years, including palliative care at end-of-life. Previous studies have illustrated that the role of the general practitioner (GP) in a community palliative care setting can require considerable coordination.¹ It may also be associated with high levels of uncertainty as GPs must navigate who is responsible for providing various aspects of care for an older person.¹ For individuals aged 85 years and older, residential aged care facilities (RACFs) are the most common place of death, a setting in which GPs already provide the majority of primary care services.^{2 3} There is therefore, increasing need for an interdisciplinary model of palliative care delivery, where GPs provide end-of-life care alongside community and hospital-based palliative care services.⁴ Despite growing demand for such service delivery, little is currently known about the experience of Australian GPs working in this setting, and the way they interact with other services when delivering end-of-life care to RACF residents. <h3><b>Aim</b>/<b>Objectives</b></h3> The aim of this project is to better understand the way in which GPs deliver end-of-life care in the RACF setting. It also aims to explore GP’s interactions with community or hospital-based palliative medicine services, and opportunities for future service development. <h3>Methods</h3> This study is currently in progress. It follows a qualitative study design, using a phenomenological approach to data collection and analysis. The study is set within RACFs in metropolitan Melbourne. GPs responsible for providing end-of-life care to patients within RACFs are to be recruited, and will each participate in a semi-structured interview. Interviews will be audio-recorded, transcribed and coded using NVivo. Data analysis will be conducted iteratively through a constant, comparative approach until thematic saturation is achieved. <h3>Findings</h3> Recruitment and data collection are currently underway and will be completed by July. Preliminary findings will be presented. <h3>Implications</h3> It is expected that findings from this research will highlight the current experiences of Australian GPs delivering end-of-life care to older Australians living in RACFs. Results will illustrate the ways in which GPs interact with various services, including community and hospital palliative care teams in order to provide quality end-of-life care within RACFs. Study findings may also indicate opportunities for service optimisation, with a view to cultivating high quality and effective palliative care services for Australia’s ageing population in future. <h3>References</h3> Herrmann A, Carey ML, Zucca AC, Boyd LAP, Roberts BJ. Australian GPs’ perceptions of barriers and enablers to best practice palliative care: a qualitative study. <i>BMC Palliative Care,</i> 2019;<b>18</b>(1):90-. Australian Institute of Health and Welfare. Interfaces between aged care and health systems in Australia—where do older Australians die? Canberra: AIHW; 2021. Reed RL. Models of general practitioner services in residential aged care facilities. <i>Aust Fam Physician</i>. 2015;<b>44</b>(4):176–9. NSW Ministry of Health. End of Life and Palliative Care Framework 2019–2024, North Sydney: 2019.