Implementation of a clinical interview guide to Multidimensional needs assessment in Palliative care (MAP): A multicenter mixed-methods feasibility study

Abstract

Palliative care; Needs assessment; Mixed-methods study

Cures pal·liatives; Avaluació de necessitats; Estudi de mètodes mixtos

Cuidados paliativos; Evaluación de necesidades; Estudio de métodos mixtos

A recent systematic review highlighted the lack of consensus on the needs that should be assessed in palliative care to develop the initial therapeutic plan. An agreed clinical interview guide for Multidimensional needs Assessment in Palliative Care (MAP) has recently been proposed.

To evaluate the feasibility of implementing the MAP guide in clinical practice.

A multicenter explanatory sequential mixed-methods feasibility study was conducted, assessing five indicators: a) acceptability to patients and family members (assessed by phone); b) participation (proportion of eligible patients assessed); c) applicability (time to administer); d) clinical utility as perceived by physicians; and e) implementation in practice. Twenty-four palliative care physicians across 10 services (outpatient, in-patient, domiciliary care) administered the MAP guide in 239 initial assessments of patients with advanced cancer. A focus group was conducted with 17 of the physicians to gather insights.

Indicators of acceptability, participation, applicability, and perceived clinical utility were fulfilled in over 90% of interviews. Implementation fell just short of the criterion (78% of needs assessed vs. 80% threshold). Patients and families provided highly positive feedback on the appropriateness of the MAP guide. Physicians found it flexible and easy to integrate into clinical practice, helping them structure the initial assessment and offer a much more comprehensive assessment of patients' needs.

The study supports the feasibility of using the MAP guide to explore palliative care needs. The MAP guide can help ensure that professionals do not overlook unmet needs, which could increase suffering and undermine quality of life.

Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional (FEDER) grant number PI19/01901. The funders had no involvement in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.