The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial
Complex advance care planning intervention in general practice (ACP-GP): a cluster-randomised controlled trial.
Advance care planning (ACP) is an iterative communication process about patients' preferences for future care. In general practice, there are barriers to ACP at patient, GP, and healthcare-system levels. A complex intervention may be necessary to reduce barriers. ⋯ ACP-GP did not improve patient engagement and GP self-efficacy more than usual care. Both groups showed patterns of increase from baseline. Trial procedures and the COVID-19 pandemic may have increased awareness about ACP.
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The new Scottish GP contract commenced in April 2018 with a stated aim of mitigating health inequalities. ⋯ Four years after the start of the new GP contract in Scotland, patients' experiences of GP consultations suggest that the inverse care law persists.