GPs volunteered to participate

in the study. All PAMINO-trained GPs and a random sample of other GPs from the same region were invited to include patients in the study. Patients were eligible for inclusion in the study if they fulfilled the Verteporfin order following criteria: (a) being in a palliative situation with cancer, where the GP would not be surprised if they died within 6months, and having no other disease with a lower life expectancy, (b) adult (at least 18years of age), (c) sufficient command of German to understand the study Inhibitors,research,lifescience,medical information and the questionnaires and (d) outpatient care by a GP who participated in the study as well. Patients and GPs had to give their informed and written consent to participate. Data collection Participating Inhibitors,research,lifescience,medical GPs informed eligible patients in their practice about the study. Patients were only included if they consented to participate. After

inclusion in the study, GPs once a month gave patients a questionnaire containing the QLQ-C15-PAL and the POS. Patients sent the questionnaires to the study centre in postage-paid return envelopes immediately after they filled them out. For study purposes (follow-up), patients were given a pseudonym number printed on the questionnaires to ensure confidentiality. The study centre was not able to identify patients personally; GPs were not informed Inhibitors,research,lifescience,medical of patients’ individual answers. The Quality of Life Questionnaire Core 15 Palliative (QLQ-C15-PAL) [7] was developed as a core instrument to measure QoL especially in cancer patients

in palliative care. It consists of 15 questions which are transformed into two function scales (‘Physical Functioning’, ‘Emotional Functioning’), seven symptom scales (‘Fatigue’, ‘Nausea/Vomiting’, Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical ‘Pain’, ‘Dyspnoea’, ‘Insomnia’, ‘Appetite loss’, ‘Constipation’) and an ‘Overall quality of life’ scale. Patients should answer the questions according to their experiences during the previous week. Responses to 14 questions are given on a four-point Likert scale with 1 ‘Not at all’, 2 ‘A little’, 3 ‘Quite a bit’, and 4 ‘Very much’, the question to overall QoL allows answers between 1 ‘Very poor’ and 7 ‘Excellent’. The QoL, else function and symptom scales take values between 0 and 100 with higher values indicating a higher QoL, higher functioning and higher symptom burden, respectively. The Palliative Care Outcome Scale (POS) [8] is used to measure outcome in palliative care. It consists of 12 questions covering the main components of palliative care. Eight questions have a 5-point Likert-scale response from 0 (not at all) to 4 (overwhelming), two questions have 3 answer options (0-2-4), one question (main problems of the previous 3days) is answered in free text and the last question asks patients if they needed help with filling out the questionnaire (0 – no, 1 – help from family or friend, 2 – help from staff).