Abstract
Background
Patients with an advanced illness often experience multiple symptoms in different dimensions (physical, social, psychological, spiritual). Simultaneously occurring symptoms may interact, with additive effects on quality of life. Whereas palliative care guidelines usually focus on single symptoms, it is likely that management of multiple symptoms is often not integrated and can be improved.
Objective
To improve quality of life in patients with life-limiting diseases, by developing a tool that improves timely and adequate assessment and treatment of simultaneously occurring symptoms.
Methods
In phase 1 the MuSt-PC is developed, a tool that integrates multidimensional screening and management of symptoms. First, we perform a systematic review to identify strategies for multidimensional assessment and management of simultaneously occurring symptoms. Second, a nationwide cross-sectional study is conducted to identify common combinations of symptoms in patients with advanced illness. Third, input from focus groups will provide insight in barriers and facilitators for successful implementation of the tool. Fourth, a RAND Delphi study is performed to develop consensus-based management strategies for combinations of symptoms. In phase 2, the effectiveness of the MuSt-PC is tested in a prospective stepped-wedge trial. The tool is further refined and disseminated in phase 3.
Results
This project results in the MuSt-PC, including treatment strategies for common combinations of multiple symptoms. Moreover, it provides insight into the feasibility and effectiveness of the MuSt-PC, with quality of life as the primary endpoint. When the tool is effective we will disseminate the MuSt-PC nationwide and internationally, in a form that can be integrated in electronic medical records.
Conclusions
This national project runs from 2017 to 2020 and delivers valuable information on the occurrence of multidimensional symptoms and a strategy to manage these symptoms. If successful, it will improve the quality of life of patients with an advanced illness.
Patients with an advanced illness often experience multiple symptoms in different dimensions (physical, social, psychological, spiritual). Simultaneously occurring symptoms may interact, with additive effects on quality of life. Whereas palliative care guidelines usually focus on single symptoms, it is likely that management of multiple symptoms is often not integrated and can be improved.
Objective
To improve quality of life in patients with life-limiting diseases, by developing a tool that improves timely and adequate assessment and treatment of simultaneously occurring symptoms.
Methods
In phase 1 the MuSt-PC is developed, a tool that integrates multidimensional screening and management of symptoms. First, we perform a systematic review to identify strategies for multidimensional assessment and management of simultaneously occurring symptoms. Second, a nationwide cross-sectional study is conducted to identify common combinations of symptoms in patients with advanced illness. Third, input from focus groups will provide insight in barriers and facilitators for successful implementation of the tool. Fourth, a RAND Delphi study is performed to develop consensus-based management strategies for combinations of symptoms. In phase 2, the effectiveness of the MuSt-PC is tested in a prospective stepped-wedge trial. The tool is further refined and disseminated in phase 3.
Results
This project results in the MuSt-PC, including treatment strategies for common combinations of multiple symptoms. Moreover, it provides insight into the feasibility and effectiveness of the MuSt-PC, with quality of life as the primary endpoint. When the tool is effective we will disseminate the MuSt-PC nationwide and internationally, in a form that can be integrated in electronic medical records.
Conclusions
This national project runs from 2017 to 2020 and delivers valuable information on the occurrence of multidimensional symptoms and a strategy to manage these symptoms. If successful, it will improve the quality of life of patients with an advanced illness.
| Original language | English |
|---|---|
| Pages (from-to) | E60-E61 |
| Journal | Journal of Pain and Symptom Management |
| Volume | 56 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2018 |