Assessing the sensitivity and acceptability of the Royal Marsden Palliative Care Referral “Triggers” Tool for out-patients with cancer

Author:

Kamal Laila1,Kano Yuki1,Stevens Anna-Marie1,Mohammed Kabir1,Pattison Natalie2,Perkins Margaret1,Popat Sanjay1,Benson Charlotte1,Minton Ollie3,Laverty Diane,Wiseman Theresa4,Mayland Catriona R5,Gough Nicholas6,Williams Caroline7,Want Julie1,Tweddle Andrew1,Wood Jayne1,Droney Joanne1

Affiliation:

1. The Royal Marsden NHS Foundation Trust

2. University of Hertfordshire and East & North Herts NHS Trust

3. University Hospitals Sussex, NHS Foundation Trust

4. Kings College London

5. University of Sheffield

6. Guys and St Thomas NHS Foundation Trust

7. University College London Hospital

Abstract

Abstract

Purpose: To evaluate the use, acceptability, and experience of a seven-item palliative care referral screening tool in an outpatient oncology setting. Methods: Atwo-phase convergent parallel mixed methods study. Patient participants who met any of the “Royal Marsden Triggers Tool” criteria were compared with those who did not in terms of demographic data, palliative care needs (Integrated Palliative Outcome Scale, IPOS) and quality of life indicators (EORTC-QLQ-C30). In-depth interviews were carried out with patients and oncology staff about their views and experience of the “Royal Marsden Triggers tool”. Qualitative and quantitative data were triangulated at data interpretation. Results: 348 patients were recruited to the quantitative phase of the study of whom 53% met at least one of the Triggers tool palliative care referral criteria. When compared with patients who were negative using the Triggers tool, “Royal Marsden Triggers tool” positive patients had a lower quality of life (EORTC QLQ-C30 Global Health Status scale (p<0.01)) and a higher proportion had severe or overwhelming physical needs on IPOS (38% versus 20%, p<0.001). Median survival of “Royal Marsden Triggers tool” positive patients was 11.7 months. 16 staff and 19 patients participated in qualitative interviews. The use of the tool normalized palliative care involvement, supporting individualized care and access to appropriate expertise. Conclusion The use of a palliative care referral tool streamlines palliative care within oncology outpatient services and supports teams working together to provide an early holistic patient-centered service. Further research is needed to evaluate the effectiveness and feasibility of this approach.

Publisher

Research Square Platform LLC

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