Instruments for the identification of patients in need of palliative care in the hospital setting: a systematic review of measurement properties

Lüthi, Fabienne Teike; MacDonald, Ibo; Amoussou, Joëlle Rosselet; Bernard, Mathieu; Borasio, Gian Domenico; Ramelet, Anne‐Sylvie

doi:10.11124/jbies-20-00555

Cited by 6 publications

(8 citation statements)

References 79 publications

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“…The focus of the clinical improvement projects was to increase the identification of palliative care needs and care planning through the use of the SPICT™. Two reviews (one of these included a survey study) 18 31 and two theses were included 28 29 (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the included records ten were studies conducted in European countries 20 – 22 24 30 – 33 37 38 ; seven in Asia 23 25 27 39 – 42 ; three in the USA 28 29 36 ; two in Australia 34 35 ; one in South Africa [ 43 ] one in Chile [ 26 ] and one in Peru [ 44 ], and one paper was a review performed by authors based in Switzerland [ 18 ]. Of note the systematic review and survey of European primary care GP practice to identify patients for palliative care revealed that the United Kingdom was the only European country at the time that incorporated the SPICT™ to identify palliative care needs in primary and secondary care in clinical guidelines [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of note the tool did not meet the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria [ 18 ]. However arguably these criteria may not be the most appropriate criteria on which to base an assessment of the SPICT™ given that it was never meant to be used to objectively measure a parameter such as prognosis; Highet et al [ 2 ] were clear about the remit of the tool i.e., “help clinicians working in primary and secondary care recognise when their patients might be at risk of dying and likely to benefit from supportive and palliative care in parallel with appropriate ongoing management of their advanced conditions.” [ 2 ], p11.…”

Section: Discussionmentioning

confidence: 99%

“…No current or planned systematic or scoping reviews specifically on this topic were identified. A systematic review by Teike Luthi, et al [ 18 ], examining instruments for the identification of patients in need of palliative care in the hospital setting was identified. The current scoping review differs from the systematic review by Teike Luthi, et al [ 18 ] as the aim was to identify and describe all research related to how the SPICT™ is used in end-of-life discussions and what influence this has on advance care planning and goals of care.…”

Section: Introductionmentioning

confidence: 99%

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Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

Mahura,

Karle,

Sayers

et al. 2024

BMC Palliat Care

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Background In order to mitigate the distress associated with life limiting conditions it is essential for all health professionals not just palliative care specialists to identify people with deteriorating health and unmet palliative care needs and to plan care. The SPICT™ tool was designed to assist with this. Aim The aim was to examine the impact of the SPICT™ on advance care planning conversations and the extent of its use in advance care planning for adults with chronic life-limiting illness. Methods In this scoping review records published between 2010 and 2024 reporting the use of the SPICT™, were included unless the study aim was to evaluate the tool for prognostication purposes. Databases searched were EBSCO Medline, PubMed, EBSCO CINAHL, APA Psych Info, ProQuest One Theses and Dissertations Global. Results From the search results 26 records were reviewed, including two systematic review, two theses and 22 primary research studies. Much of the research was derived from primary care settings. There was evidence that the SPICT™ assists conversations about advance care planning specifically discussion and documentation of advance care directives, resuscitation plans and preferred place of death. The SPICT™ is available in at least eight languages (many versions have been validated) and used in many countries. Conclusions Use of the SPICT™ appears to assist advance care planning. It has yet to be widely used in acute care settings and has had limited use in countries beyond Europe. There is a need for further research to validate the tool in different languages.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

Mahura,

Karle,

Sayers

et al. 2024

BMC Palliat Care

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“…They did not conduct a meta-analysis to pool the clinical performance of the instruments. [19][20][21][22][23] Additionally, existing reviews only included instruments used within a single type of setting, such as primary care settings or hospital settings. 19-21 23 Therefore, it is unclear how screening instruments were used across different settings, and whether variations exist in their clinical performance across these instruments and different settings.…”

Section: Introductionmentioning

confidence: 99%

Screening instruments for early identification of unmet palliative care needs: a systematic review and meta-analysis

Xie,

Ding,

Jiao

et al. 2023

BMJ Support Palliat Care

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BackgroundThe early detection of individuals who require palliative care is essential for the timely initiation of palliative care services. This systematic review and meta-analysis aimed to (1) Identify the screening instruments used by health professionals to promote early identification of patients who may benefit from palliative care; and (2) Assess the psychometric properties and clinical performance of the instruments.MethodsA comprehensive literature search was conducted in PubMed, Embase, CINAHL, Scopus, CNKI and Wanfang from inception to May 2023. We used the COnsensus-based Standards for the Selection of Health Measurement INstruments to assess the methodological quality of the development process for the instruments. The clinical performance of the instruments was assessed by narrative summary or meta-analysis. Subgroup analyses were conducted where necessary. The quality of included studies was assessed using the Newcastle-Ottawa Scale and the Cochrane Collaboration’s risk of bias assessment tool.ResultsWe included 31 studies that involved seven instruments. Thirteen studies reported the development and validation process of these instruments and 18 studies related to assessment of clinical performance of these instruments. The content validity of the instruments was doubtful or inadequate because of very low to moderate quality evidence. The pooled sensitivity (Se) ranged from 60.0% to 73.8%, with high heterogeneity (I2 of 88.15% to 99.36%). The pooled specificity (Sp) ranges from 70.4% to 90.2%, with high heterogeneity (I2 of 96.81% to 99.94%). The Supportive and Palliative Care Indicators Tool (SPICT) had better performance in hospitals than in general practice settings (Se=79.8% vs 45.3%, p=0.004; Sp=59.1% vs 97.0%, p=0.000).ConclusionThe clinical performance of existing instruments in identifying patients with palliative care needs early ranged from poor to reasonable. The SPICT is used most commonly, has better clinical performance than other instruments but performs better in hospital settings than in general practice settings.

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Identifying Nursing Home Residents with Unmet Palliative Care Needs: A Systematic Review of Screening Tool Measurement Properties

Cole

Roydhouse

Fink

et al. 2023

Journal of the American Medical Directors Association

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Instruments for the identification of patients in need of palliative care in the hospital setting: a systematic review of measurement properties

Cited by 6 publications

References 79 publications

Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

Screening instruments for early identification of unmet palliative care needs: a systematic review and meta-analysis

Identifying Nursing Home Residents with Unmet Palliative Care Needs: A Systematic Review of Screening Tool Measurement Properties

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