[Speaking and deciding with a serious illness].

It is a GP's task to identify patients as palliative patients at an early stage using suitable instruments. As part of a multidimensional basic assessment, the needs and expectations of the patient and their loved ones are recorded. During the interview, open questions are cla-rified, concerns are addressed and treatment options are discussed; a treatment goal is then jointly developed.

[Palliative Care im Migrationskontext].

Palliative care in the migration context is mainly a diversity-sensitive treatment and care tailored to the individual person. In the case of serious advanced illness and especially at the end of life, people with a migration background have fundamentally similar basic needs as the rest of the population. They want to be as free as possible from pain and other distressing symptoms, and in the process of dying they want encouragement through their relatives and support from competent and committed health professionals with whom they can communicate in their native language whenever possible.

[Trauma Disorders - A Relevant Health Problem].

Trauma Disorders - A Relevant Health Problem In medical practice traumatic stress disorders are underdiagnosed. Post-traumatic stress disorder (PTSD) must be considered in case of pronounced need for control, severe anxiety and restlessness, jumpiness, mental torpor, dissociative disorders, social withdrawal, distrust or vegetative over-arousal. Simple screening instruments such as the "Primary Care PTSD Screen" are suitable for an initial assessment.

[Early recognition or screening of dementia in general practice].

Early recognition or screening of dementia in general practice General practitioners play a key role in timely dementia diagnosis. In view that there are currently no drugs to prevent the progression of dementia or are effective in patients with mild cognitive impairment, a general screening of older people to recognize pre-symptomatic stages of dementia is not recommended. Crucial for a timely diagnosis is the GP's perception of warning signs, so-called "red flags".

Decision-making capacity evaluations: the role of neuropsychological assessment from a multidisciplinary perspective.

Decision-making capacity (DMC) in aging adults has become increasingly salient as the number of older adults, life expectancy, and the amount of wealth to be transferred from older generations have all increased. The accurate and reliable determination of older adults' DMC is a particularly important topic given its implication in legal, financial, and health decisions. Based upon the four-ability DMC model promulgated by Appelbaum and Grisso in the 1980's, a number of MacArthur Competence Assessment Tools have been developed and widely utilized.

Roadmap for the treatment of heart failure patients after hospital discharge: an interdisciplinary consensus paper.

The transition period from the hospital to the outpatient setting is a critical phase when managing heart failure. A well-structured transition is paramount and helps to ensure a tight follow-up schedule for the heart failure patient, thereby improving treatment outcomes. This article aims to provide guidance for the first three follow-up visits after hospital discharge, with a focus on monitoring heart failure patients and up-titrating their medication in primary care.

[Fatigue - a Common Symptom in General Practice].

Fatigue - a Common Symptom in General Practice When patients suffering from fatigue consult a GP surgery, GPs should understand what patients mean by fatigue, how strongly they are affected in everyday life and how they themselves explain the symptom. In a next step, dangerous diseases such as depression, addiction or sleep apnea syndrome must be excluded. The main somatic and psychiatric causes of fatigue should be explored simultaneously with a more in-depth history.

Advance Care Planning for People with Dementia: The Role of General Practitioners.

General practitioners (GPs) play a key role in the timely diagnosis of dementia and also in advance care planning (ACP). They often have known patients and their families for decades and are familiar with their values and treatment preferences; they are, therefore, in a position to initiate the ACP process even before the appearance of the first symptoms of dementia and certainly following disclosure of the diagnosis. To do so, they should recognise whether patients are receptive to an ACP consultation or whether they might reject it for personal, social or cultural reasons.

General practitioners' attitudes towards early diagnosis of dementia: a cross-sectional survey.

Background: Dementia is often underdiagnosed in general practice, which may be based on general practitioners' (GPs') knowledge and emotional factors as well as external problems. This study aimed to describe GPs' attitudes toward early diagnosis of dementia.

Methods: Cross-sectional postal survey in Switzerland in 2017.

Early diagnosis and management of dementia in general practice - how do Swiss GPs meet the challenge?

Introduction: In general practice, the diagnosis of dementia is often delayed. Therefore, the Swiss National Dementia Strategy 2014 concluded that action was needed to improve patient care. Little is known about GPs’ confidence in and approach to the diagnosis, disclosure and post-diagnostic management of individuals with dementia in Switzerland.

Reasons for and Frequency of End-of-Life Hospital Admissions: General Practitioners' Perspective on Reducing End-of-Life Hospital Referrals.

Background: Many palliative care patients are admitted to hospital shortly before death even though the acute hospital setting is not considered ideal for end-of-life care (EOLC).

Objectives: This study aimed to evaluate General Practitioners' (GPs') perspective on the frequency of and reasons for hospital referrals of these patients.

Methods: Cross-sectional survey involving a stratified random sample of 2000 GPs in Switzerland in 2014.

General Practitioners' Attitudes towards Essential Competencies in End-of-Life Care: A Cross-Sectional Survey.

Background: Identifying essential competencies in end-of-life care, as well as general practitioners' (GPs) confidence in these competencies, is essential to guide training and quality improvement efforts in this domain.

Aim: To determine which competencies in end-of-life care are considered important by GPs, to assess GPs' confidence in these competencies in a European context and their reasons to refer terminally ill patients to a specialist.

Design And Setting: Cross-sectional postal survey involving a stratified random sample of 2000 GPs in Switzerland in 2014.

Interprofessional Silence at the End of Life: Do Swiss General Practitioners and Hospital Physicians Sufficiently Share Information About Their Patients?

Background: Empirical research suggests that the quality of patient care at the end of life (EOL) is influenced by the effectiveness of the collaboration between the general practitioners (GPs) and hospital physicians (HPs).

Aim: To identify possible difficulties and barriers to effective collaboration at the EOL between GPs and HPs from the perspective of Swiss GPs.

Design: Twenty-three qualitative semi-structured interviews with GPs were transcribed and analyzed using Mayring's content analysis.

The utility of standardized advance directives: the general practitioners' perspective.

Advance directives (AD) are written documents that give patients the opportunity to communicate their preferences regarding treatments they do or do not want to receive in case they become unable to make decisions. Commonly used pre-printed forms have different formats. Some offer space for patients to (a) appoint a surrogate decision maker, and/or (b) to determine future medical treatments and/or (c) give a statement of personal values.

Advance directives and the impact of timing. A qualitative study with Swiss general practitioners.

Principles: Advance directives are seen as an important tool for documenting the wishes of patients who are no longer competent to make decisions in regards to their medical care. Due to their nature, approaching the subject of advance directives with a patient can be difficult for both the medical care provider and the patient. This paper focuses on general practitioners' perspectives regarding the timing at which this discussion should take place, as well as the advantages and disadvantages of the different moments.

Discontinuation of secondary prevention medication after myocardial infarction - the role of general practitioners and patients.

Background: Despite the significant benefits of secondary prevention (SP) medication after acute myocardial infarction (MI), evidence suggests that these medications are neither consistently prescribed nor appropriately adhered to by patients. The aim of this study was to investigate the role of general practitioners (GPs) and patients regarding discontinuation of SP medication after MI and reasons for discontinuation.

Methods: In this observational study, GPs of patients who had suffered acute MI provided information on discontinuation of SP medication 6 and 12 months after hospital discharge.

Acute cough illness in general practice - predictive value of clinical judgement and accuracy of requesting chest x-rays.

The aim of the study was to evaluate the accuracy of GPs' initial clinical judgement regarding presence or absence of pneumonia and to assess GPs' strategy for requesting chest X-rays in patients presenting with acute cough. GPs were asked to rate their suspicion of pneumonia based on clinical assessment alone and to protocol their decision to perform chest X-rays in 212 consecutive patients. These judgements were compared to the final diagnosis as determined by chest X-ray or uneventful recovery (four weeks).

[Acute hospital admissions among nursing home residents--benefits and potential harms].

Nursing home residents are often referred by their general practitioners to the emergency department or to a geriatric hospital. Hospitalization is mainly perceived as a burden by elderly people; it may also contribute to a reduction of their mental abilities and functional decline. Reasons for admitting patients from nursing homes include infections, exacerbation of pre-existing cardiovascular disease and falls.

Management and outcome of severely elevated blood pressure in primary care: a prospective observational study.

Objective: In primary care the management of patients with acute severely elevated blood pressure (BP) is challenging. The aim of the study was to evaluate the initial management and outcome of patients presenting to their general practitioner (GP) with severe high blood pressure.

Methods: Twenty five general practitioners prospectively identified 164 patients presenting with severely elevated blood pressure (systolic BP >180 mm Hg and/or diastolic BP >110 mm Hg).

[High-quality hospital discharge summaries - general practitioners expectations].

Hospital discharge summaries ensure treatment continuity after hospital discharge. In Switzerland discharge letters are a celebrated custom and a tool for training young colleagues. The primary purpose is to guarantee high-quality care of patients treated by hospital staff and general practitioners.