Bath, P.A. (2015) A Pilot Randomized Controlled Trial of a Holistic Needs Assessment Questionnaire in a Supportive and Palliative Care Service. Journal of Pain and Symptom Management. Available online 16 June 2015. ISSN 0885-3924
Abstract
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, 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: difference in score between MYCAW patient-nominated concern 1 on the patient self-scoring visual analogue scale at baseline and the two-week follow-up. Secondary outcomes: difference in scores in the MYCAW, EQ-5D, and 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; df = 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 EQ5D and PEI 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.
Metadata
Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2015 Elsevier. This is an author produced version of a paper subsequently published in Journal of Pain and Symptom Management. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Palliative care; holistic needs assessment questionnaire; SPARC; MYCAW; EQ5D |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Social Sciences (Sheffield) > Information School (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 30 Jun 2015 13:41 |
Last Modified: | 23 Jun 2016 03:33 |
Published Version: | http://dx.doi.org/10.1016/j.jpainsymman.2015.05.01... |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | https://doi.org/10.1016/j.jpainsymman.2015.05.010 |