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18-01-2012 | Legal medicine | Article

Palliative care professionals use outcome measures in clinical practice and research


Free abstract

MedWire News: Both clinicians and researchers make use of patient-reported outcome measures (PROMs), shows a study.

"Traditionally, PROMs were used in clinical trials to measure treatment effects but increasingly are employed in clinical practice to prioritize problems, communicate, screen, monitor change, record treatment response and train new staff, and in clinical audit and clinical governance," write study author Irene Higginson (King's College London, UK) and colleagues. "Their use helps ensure care is orientated towards the needs of the patients and families, rather than focusing on test reports or process measures."

In this study, published in BMJ Supportive and Palliative Care, the team developed an online questionnaire to evaluate the views of clinicians and researchers in terms of the use of outcome measures.

The survey was completed by 392 palliative care professionals working in clinical care, clinical audit, or research in Europe (n=311) or Africa (n=81). The questionnaire was made up of 59 questions focused on the outcome measures they used and why. Higginson et al also asked which questions were most useful in two commonly used multidimensional measures of patient reported outcomes: the Palliative care Outcome Scale (POS) and the Support Team Assessment Schedule (STAS).

Overall, 68.1% of the European respondents and 73.3% of the African respondents had experience using outcome measures.

The most commonly used outcome measures were the Karnofsky Performance Scale (KPS), the Edmonton Symptom Assessment Scale (ESAS), and the POS. These three were used by over one-quarter of the clinical practitioners and one 10th of the researchers. These measures have between one and 10 items, which the team says suggests palliative professionals prefer to use short questionnaires.

In general, similar items in both the POS and STAS measures were rated most useful by the practitioners; these were questions about pain, symptoms, emotional needs and family concerns, which the authors say "reflect the holistic nature of palliative care."

They add: "Measures in palliative care must perform the complex job of capturing individual needs and how they change and help palliative care services to address patient/family problems."

By Chloe McIvor

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