What diagnostic tools are available for the identification of palliative care patients in primary care

A systematic review

Journal of Palliative Care 2015;3(2):118-123

Walsh RI, Mitchell G, Francis L, Van Driel ML.

Early identification of those nearing the end of life benefits patients, clinicians and the community. With its easily accessible web platform, the SPICT seems the most suitable tool for trial and adaptation in Australia

Conclusion

Early identification of those nearing the end of life benefits patients, clinicians and the community. The identification process is both subjective and challenging. Tools that are evidence-based, that are transferable across healthcare systems, and that standardise the early identification process may promote the systematic early identification of palliative patients. The four tools discussed here stimulate consideration of potential illness trajectories; their prompts can encourage discussions between clinicians and patients about life-limiting illness and help diminish the potential awkwardness of such discussions.

These tools provide a framework that is applicable to multiple disease states and that can facilitate communication between clinicians in community settings and those in hospital settings. With its easily accessible web platform, the SPICT seems the most suitable tool for trial and adaptation in Australia. The tools need to be refined by clinicians in the front line with the aim of improving the quality of patient care and optimising communication between all parties involved in that care. The impact of the tools on relevant outcomes should be studied. These outcomes could include patient-orientated measures, carer outcomes, and health system outcomes like service utilisation and cost. The application of best quality evidence to patient care can also be measured.