A pilot randomised controlled trial of a holistic needs assessment questionnaire in a supportive and palliative care service

AHMED, Nisar, HUGHES, P, WINSLOW, M, BATH, P, COLLINS, Karen and NOBLE, B (2015). A pilot randomised controlled trial of a holistic needs assessment questionnaire in a supportive and palliative care service. Journal of Pain and Symptom Management, 50 (5), 587-598.

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Context : At present, there is no widely used systematic evidence-based holistic approach to assessment of patients' supportive and palliative care needs. Objectives : To determine whether the use of a holistic needs assessment questionnaire, Sheffield Profile for Assessment and Referral for Care (SPARC), will lead to improved health care outcomes for patients referred to a palliative care service. Methods : This was an open, pragmatic, randomized controlled trial. Patients (n = 182) referred to the palliative care service were randomized to receive SPARC at baseline (n = 87) or after a period of two weeks (waiting-list control n = 95). Primary outcome measure is the difference in score between Measure Yourself Concerns and Wellbeing (MYCAW) patient-nominated Concern 1 on the patient self-scoring visual analogue scale at baseline and the two-week follow-up. Secondary outcomes include difference in scores in the MYCAW, EuroQoL (EQ-5D), and Patient Enablement Instrument (PEI) scores at Weeks 2, 4, and 6. Results : There was a significant association between change in MYCAW score and whether the patients were in the intervention or control group (χ2trend = 5.51; degrees of freedom = 1; P = 0.019). A higher proportion of patients in the control group had an improvement in MYCAW score from baseline to Week 2: control (34 of 70 [48.6%]) vs. intervention (19 of 66 [28.8%]). There were no significant differences (no detectable effect) between the control and intervention groups in the scores for EQ-5D and Patient Enablement Instrument at 2-, 4-, or 6-week follow-up. Conclusion : This trial result identifies a potential negative effect of SPARC in specialist palliative care services, raising questions that standardized holistic needs assessment questionnaires may be counterproductive if not integrated with a clinical assessment that informs the care plan. Key Words : Palliative care; holistic needs assessment questionnaire; SPARC; MYCAW; EQ-5D; PEI

Item Type: Article
Research Institute, Centre or Group: Centre for Health and Social Care Research
Identification Number: 10.1016/j.jpainsymman.2015.05.010
Depositing User: Karen Collins
Date Deposited: 02 Jun 2015 13:24
Last Modified: 19 Oct 2016 23:03
URI: http://shura.shu.ac.uk/id/eprint/10089

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