Abstract
Patients', carers' and health professionals' perspectives on the use of the Prognosis in Palliative care study (PiPS) predictor models: A qualitative study
Author(s):
Background: Patients with advanced cancer and their carers often wish to know how long they have left to live. Yet health care professionals' (HCPs) predictions of survival are typically unreliable, over-optimistic and subjective. The PiPS prognostic models use objective clinical data to predict whether palliative cancer patients will die within “days”, “weeks” or “months+”. A previous study shows the PiPS models are at least as good, or more accurate than, HCPs' predictions. We are currently validating PiPS in a large sample of palliative cancer patients. This paper presents qualitative data on acceptability of PiPS (and other prognostic tools) to patients, carers and HCPs.
Aim: To determine acceptability of prognostic tools to patients, carers and HCPs and to identify barriers and facilitators to clinical use.
Design: Qualitative study nested within larger quantitative validation.
Setting/participants: Semi-structured interviews were conducted with 70 patients, carers and HCPs. Inpatients and carers were recruited from two hospices. HCPs were recruited from a variety of palliative care settings (hospice, hospital and community) and include palliative care specialists, oncologists, GPs and specialist nurses.
Results: Patients and carers were positive about clinicians' use of PiPS to estimate prognosis at end-of-life. The majority of patients and carers expressed a desire for detailed prognostic information. Most agreed that having life expectancy presented as either days, weeks, months or years, made sense and was helpful to them. HCPs conveyed a variety of opinions about use of PiPS in practice. These included; ease of use; time constraints; difficulty with missing data (e.g. blood results); use as an educational/training resource; and resistance to change in practice.
Conclusions: Our study demonstrates the acceptability of PiPS to patients and carers. We identified a number of important facilitators and barriers to use, that need to be addressed if PiPS is to be implemented in clinical practice.
Author(s):
Background: Patients with advanced cancer and their carers often wish to know how long they have left to live. Yet health care professionals' (HCPs) predictions of survival are typically unreliable, over-optimistic and subjective. The PiPS prognostic models use objective clinical data to predict whether palliative cancer patients will die within “days”, “weeks” or “months+”. A previous study shows the PiPS models are at least as good, or more accurate than, HCPs' predictions. We are currently validating PiPS in a large sample of palliative cancer patients. This paper presents qualitative data on acceptability of PiPS (and other prognostic tools) to patients, carers and HCPs.
Aim: To determine acceptability of prognostic tools to patients, carers and HCPs and to identify barriers and facilitators to clinical use.
Design: Qualitative study nested within larger quantitative validation.
Setting/participants: Semi-structured interviews were conducted with 70 patients, carers and HCPs. Inpatients and carers were recruited from two hospices. HCPs were recruited from a variety of palliative care settings (hospice, hospital and community) and include palliative care specialists, oncologists, GPs and specialist nurses.
Results: Patients and carers were positive about clinicians' use of PiPS to estimate prognosis at end-of-life. The majority of patients and carers expressed a desire for detailed prognostic information. Most agreed that having life expectancy presented as either days, weeks, months or years, made sense and was helpful to them. HCPs conveyed a variety of opinions about use of PiPS in practice. These included; ease of use; time constraints; difficulty with missing data (e.g. blood results); use as an educational/training resource; and resistance to change in practice.
Conclusions: Our study demonstrates the acceptability of PiPS to patients and carers. We identified a number of important facilitators and barriers to use, that need to be addressed if PiPS is to be implemented in clinical practice.
| Original language | English |
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| Publication status | In preparation - 13 Feb 2018 |
| Event | 10th World Research Congress of the European Association of Palliative Care (EAPC) - Switzerland Bern , Bern Duration: 23 May 2018 → 26 May 2018 |
Conference
| Conference | 10th World Research Congress of the European Association of Palliative Care (EAPC) |
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| City | Bern |
| Period | 23/05/18 → 26/05/18 |