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

Abstract

Purpose

To evaluate the use, acceptability, and experience of a seven-item palliative care referral screening tool in an outpatient oncology setting.

Methods

A two-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

Three hundred forty-eight 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.

Sixteen staff and 19 patients participated in qualitative interviews. The use of the tool normalised palliative care involvement, supporting individualised 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-centred service. Further research is needed to evaluate the effectiveness and feasibility of this approach.

Metadata

Item Type:	Article
Authors/Creators:	Kamal, L. Kano, Y. Stevens, A.-M. Mohammed, K. Pattison, N. Perkins, M. Popat, S. Benson, C. Minton, O. Laverty, D. Wiseman, T. Mayland, C.R. https://orcid.org/0000-0002-1440-9953 Gough, N. Williams, C. Want, J. Tweddle, A. Wood, J. Droney, J.
Copyright, Publisher and Additional Information:	© 2024 The Authors. Except as otherwise noted, this author-accepted version of a journal article published in Supportive Care in Cancer is made available via the University of Sheffield Research Publications and Copyright Policy under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ © The Author(s) 2024. Open Access: This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Keywords:	EORTC-QLQ-C30; Early palliative care; Holistic; Integrated Palliative Outcome Scale (IPOS); Normalisation; Palliative care referral tool; Humans; Palliative Care; Male; Female; Referral and Consultation; Neoplasms; Middle Aged; Quality of Life; Aged; Adult; Outpatients; Surveys and Questionnaires; Aged, 80 and over; Ambulatory Care
Dates:	Published: November 2024 Published (online): 16 October 2024 Accepted: 3 October 2024 Submitted: 24 April 2024
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health
Depositing User:	Symplectic Sheffield
Date Deposited:	23 Oct 2024 10:58
Last Modified:	23 Oct 2024 17:54
Status:	Published
Publisher:	Springer Science and Business Media LLC
Refereed:	Yes
Identification Number:	10.1007/s00520-024-08921-5
Related URLs:	PubMed URL
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:218620

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

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