18 Are UK palliative care patients willing to participate in a trial of bispectral index (BIS) technology for assessing levels of consciousness? Findings from an exploration of feasibility for I-CAN-CARE

Krooupa, Anna-Maria; Stone, Paddy; McKeever, Stephen; Vivat, Bella

doi:10.1136/spcare-2020-pcc.18

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“…AMK derived sub-themes and themes, and mapped relationships between these and the codes and categories, assisting interpretation and conceptualisation. These were discussed further with the Study Advisory Group, and reported in AMK’s thesis [ 42 ]. For the current paper we revisited the analysis and agreed some further refinement of the themes and sub-themes.…”

Section: Methodsmentioning

confidence: 99%

“…However, all previous studies have obtained informed consent from patients/family members prior to using the technologies [ 39 – 41 ]. In contrast, our series of studies of the use of sedatives and BIS technology in palliative care in the UK included an exploratory study, investigating the acceptability of the technology in advance of introducing it into the clinical context, conducted as part of a doctoral project [ 42 ]. This study, reported here, explored the acceptability of trialling BIS in clinical practice through a qualitative investigation into what current patients, relatives of current patients, and bereaved relatives thought of this technology and its potential use with palliative care patients.…”

Section: Introductionmentioning

confidence: 99%

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Do palliative care patients and relatives think it would be acceptable to use Bispectral index (BIS) technology to monitor palliative care patients’ levels of consciousness? A qualitative exploration with interviews and focus groups for the I-CAN-CARE research programme

et al. 2022

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Background Bispectral index (BIS) monitoring uses electroencephalographic data as an indicator of patients’ consciousness level. This technology might be a useful adjunct to clinical observation when titrating sedative medications for palliative care patients. However, the use of BIS in palliative care generally, and in the UK in particular, is under-researched. A key area is this technology’s acceptability for palliative care service users. Ahead of trialling BIS in practice, and in order to ascertain whether such a trial would be reasonable, we conducted a study to explore UK palliative care patients’ and relatives’ perceptions of the technology, including whether they thought its use in palliative care practice would be acceptable. Methods A qualitative exploration was undertaken. Participants were recruited through a UK hospice. Focus groups and semi-structured interviews were conducted with separate groups of palliative care patients, relatives of current patients, and bereaved relatives. We explored their views on acceptability of using BIS with palliative care patients, and analysed their responses following the five key stages of the Framework method. Results We recruited 25 participants. There were ten current hospice patients in three focus groups, four relatives of current patients in one focus group and one individual interview, and eleven bereaved relatives in three focus groups and two individual interviews. Our study participants considered BIS acceptable for monitoring palliative care patients’ consciousness levels, and that it might be of use in end-of-life care, provided that it was additional to (rather than a replacement of) usual care, and patients and/or family members were involved in decisions about its use. Participants also noted that BIS, while possibly obtrusive, is not invasive, with some seeing it as equivalent to wearable technological devices such as activity watches. Conclusions Participants considered BIS technology might be of benefit to palliative care as a non-intrusive means of assisting clinical assessment and decision-making at the end of life, and concluded that it would therefore be acceptable to trial the technology with patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%