Interventions to increase involvement of primary care clinicians in providing palliative care: A scoping review.

Abstract

It is recognized that primary care clinicians have a critical role in ensuring access to palliative care in health systems. When primary palliative care has been examined at the system level, provision is highly variable, making the study of best practices challenging. The aim of this scoping review is to describe intervention components, implementation contexts, and evaluation approaches used in studies seeking to enhance palliative care delivery in primary care. This scoping review followed the framework and stages outlined by Arskey and O'Malley, with a descriptive analysis. Articles published from 2000 to 2025 were identified from MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Studies that described interventions involving primary care clinicians and their adult patients with any medical condition and which were evaluated using controlled or uncontrolled, quantitative or qualitative methods, were included. The search identified 8669 abstracts and 55 studies were included. Components of interventions included (1) specialist palliative care physician support (<i>n</i> = 31), (2) multidisciplinary team-based care (<i>n</i> = 36), (3) integration of new tools and resources (<i>n</i> = 36), and (4) educational and training initiatives (<i>n</i> = 39). Most interventions were multi-faceted. Regardless of patient population, support from palliative care specialists, multi-disciplinary roles and systematic approaches to identify patients were prevalent components. Supporting primary care clinicians to provide palliative care is achieved through coordinated efforts to mobilize resources within the primary care setting and intentional collaboration with external specialist teams.