Difficulty of symptom control and general practitioners' knowledge of patients' symptoms

The purpose of this study was to investigate barriers to adequate symptom control in palliative care within primary care by surveying health professionals' perceptions of their ability to control symptoms and awareness of their patients' symptoms. General practitioners (GPs) and district nurses were surveyed about general views of symptom control. Interviews with terminally ill patients were conducted, and GPs completed questionnaires about these specific patients. GPs and district nurses differed greatly in the symptoms they felt confident in controlling. There was generally low agreement between patients' and GP's reports of patients' symptoms. GPs were most likely to miss symptoms which were perceived to be difficult to control and which were less prevalent in the patient sample. As GPs and district nurses differ in the symptoms they feel confident in controlling, close teamwork between the two professions may enhance the prospects for adequate control of some symptoms. Perceived ability to control symptoms and the prevalence of symptoms may both influence which symptoms come to the attention of the GP. Unless GPs ask directly about symptoms, many symptoms are likely to be missed.