Validation of a Simple Screening Tool for Identifying Unmet Palliative Care Needs in Patients With Cancer

Glare, Paul; Chow, Kimberly

doi:10.1200/jop.2014.001487

Cited by 63 publications

(69 citation statements)

References 15 publications

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“…One recent study estimated that 13.8 percent of intensive care unit admissions met criteria for palliative care consultation, 23 and a study in a large cancer center estimated that one-third of hospitalized cancer patients should receive a palliative care consultation. 24 In addition, we found that one-third of palliative care programs did not have recommended coverage-personnel available on site during weekday business hours and by telephone at all times. SOURCE Authors' analysis of data from the 2012-13 annual surveys of the National Palliative Care Registry.…”

Section: Discussionmentioning

confidence: 96%

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Few Hospital Palliative Care Programs Meet National Staffing Recommendations

et al. 2016

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The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard. Larger palliative care programs were more likely than smaller ones to include a funded physician position, while smaller programs were more reliant upon advanced practice and registered nurses. To meet current and future palliative care needs, expanded and enhanced education, as well as supportive financing mechanisms for consultations, are needed.

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Section: Discussionmentioning

confidence: 96%

“…These can be administered by multiple types of hospital personnel, streamline the referral process, and reduce the odds that patients' needs are missed. 23,24,34 Managers should ensure that their palliative care programs collaborate with other related hospital programs such as advance care planning, case management, and pain services.…”

Section: Discussionmentioning

confidence: 99%

Few Hospital Palliative Care Programs Meet National Staffing Recommendations

et al. 2016

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“…Palliative care need assessed by external screening using the "Palliative Care Screening Tool for heart failure patients" was scored with 6.8 out of a maximum of 12 points. Using the cut-off value of >5 of the original version of the "Five Item Palliative Care Screening Tool" by Glare et al validated in cancer patients as indicator for palliative care need [27,33], almost 80% of patients would have needed palliative care. Interestingly, the treating cardiologists recognized objective parameters for palliative care needs, like symptom burden, distress or decision-making quite frequently.…”

Section: Discussionmentioning

confidence: 99%

“…Screening for palliative care need: A modified version of the "FiveItem Palliative Care Screening Tool" developed by Glare et al was used to screen for potential palliative care need by the treating cardiologists [27,33]. The "Five-Item Palliative Care Screening Tool" was developed to screen advanced cancer patients for their potential palliative care need.…”

Section: Measurementsmentioning

confidence: 99%

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Self-assessment and Screening for Palliative Care Need in Patients with Chronic Heart Failure

Ehlert¹,

Kodolitsch²,

Ullrich³

et al. 2017

J Palliat Care Med

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Objective: Patients with chronic heart failure (CHF) rarely receive palliative care today. Methods:In a cross-sectional pilot study we evaluated feasibility of self-assessment and physician-directed screening for palliative care need in CHF patients. Patients answered German versions of the "Minimal Documentation system for patients in palliative care" (MIDOS), "Distress-Thermometer" (DT), and the "Patient Health Questionnaire" (PHQ4). A modified version of the "Five-Item Palliative Care Screening Tool" was used to screen for palliative care need by the treating cardiologists.Results: 218 patients were asked to participate and 148 (67%) completed all questionnaires. Median symptom burden (MIDOS) was 7 out of 30 points (SD 4.868), overall wellbeing was two of 5 (SD 0.902), and median distress score was 6 of 10 (SD 2.318). Most frequent moderate or severe symptoms were dyspnea (52%), weakness (51%), and tiredness (49%). Significant distress (DT score>5) was indicated by 106 patients (72%). Exhaustion (79%), sleeping problems (75%), and problems with breathing (69%) were most frequent problems. Only 11% and 14% of patients presented with significant anxiety and depression, respectively (PHQ4-score>3).Palliative care need was scored with mean 6.8 out of 12 points (SD 2.223). Using a cut-off value of >5, 113 patients (76%) would have needed palliative care. Objective parameters for palliative care need (symptom burden 43%, distress 68%, decision-making 67%) were indicated, but request for palliative care by the patients, their relatives (5%) or the cardiology team (5%) was rare. Symptom burden and palliative care screening showed significant, but not clinically relevant interaction. Conclusion:This pilot study, feasibility of palliative care self-assessment and the modified screening instrument could be demonstrated in CHF patients. For comprehensive screening, both perspectives have to be included. First results indicate significant symptom burden, psychological distress and a high need for additional palliative care in CHF patients.

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PALLIA‐10, a screening tool to identify patients needing palliative care referral in comprehensive cancer centers: A prospective multicentric study (PREPA‐10)

et al. 2019

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Purpose The identification and referral of patients in need of palliative care should be improved. The French society for palliative support and care recommended to use the PALLIA‐10 questionnaire and its score greater than 3 to refer patients to palliative care. We explored the use of the PALLIA‐10 questionnaire and its related score in a population of advanced cancer patients. Methods This prospective multicentric study is to be conducted in authorized French comprehensive cancer centers on hospitalized patients on a given day. We aimed to use the PALLIA‐10 score to determine the proportion of palliative patients with a score >3. Main secondary endpoints were to determine the proportion of patients already managed by palliative care teams at the study date or referred to palliative care in six following months, the prevalence of patients with a score greater than 5, and the overall survival using the predefined thresholds of 3 and 5. Results In 2015, eighteen French cancer centers enrolled 840 patients, including 687 (82%) palliative patients. 479 (69.5%) patients had a score >3, 230 (33.5%) had a score >5, 216 (31.4%) patients were already followed‐up by a palliative care team, 152 patients were finally referred to PC in the six subsequent months. The PALLIA‐10 score appeared as a reliable predictive (adjusted ORRef≤3: 1.9 [1.17‐3.16] and 3.59 [2.18‐5.91]) and prognostic (adjusted HRRef≤3 = 1.58 [95%CI 1.20‐2.08] and 2.18 [95%CI 1.63‐2.92]) factor for patients scored 4‐5 and >5, respectively. Conclusion The PALLIA‐10 questionnaire is an easy‐to‐use tool to refer cancer inpatients to palliative care in current practice. However a score greater than 5 using the PALLIA‐10 questionnaire would be more appropriate for advanced cancer patients hospitalized in comprehensive cancer center.

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Validation of a Simple Screening Tool for Identifying Unmet Palliative Care Needs in Patients With Cancer

Abstract: The tool seems to be a valid method for identifying patients with cancer with complex PC needs who would benefit from a PC consult. Reliability testing, external validation, and demonstration of the utility of the tool as a decision aid all await confirmation.

Cited by 63 publications

References 15 publications

Few Hospital Palliative Care Programs Meet National Staffing Recommendations

Few Hospital Palliative Care Programs Meet National Staffing Recommendations

Self-assessment and Screening for Palliative Care Need in Patients with Chronic Heart Failure

PALLIA‐10, a screening tool to identify patients needing palliative care referral in comprehensive cancer centers: A prospective multicentric study (PREPA‐10)

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