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How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease: Development of a Clinical Decision Support Tool using a Delphi design

Research output: Contribution to journalArticle

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How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease : Development of a Clinical Decision Support Tool using a Delphi design. / van Vliet, Liesbeth M.; Harding, Richard; Bausewein, Claudia; Payne, Sheila; Higginson, Irene J.

In: BMC Medicine, Vol. 13, 263, 13.10.2015.

Research output: Contribution to journalArticle

Harvard

van Vliet, LM, Harding, R, Bausewein, C, Payne, S & Higginson, IJ 2015, 'How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease: Development of a Clinical Decision Support Tool using a Delphi design', BMC Medicine, vol. 13, 263. https://doi.org/10.1186/s12916-015-0449-6

APA

van Vliet, L. M., Harding, R., Bausewein, C., Payne, S., & Higginson, I. J. (2015). How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease: Development of a Clinical Decision Support Tool using a Delphi design. BMC Medicine, 13, [263]. https://doi.org/10.1186/s12916-015-0449-6

Vancouver

van Vliet LM, Harding R, Bausewein C, Payne S, Higginson IJ. How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease: Development of a Clinical Decision Support Tool using a Delphi design. BMC Medicine. 2015 Oct 13;13. 263. https://doi.org/10.1186/s12916-015-0449-6

Author

van Vliet, Liesbeth M. ; Harding, Richard ; Bausewein, Claudia ; Payne, Sheila ; Higginson, Irene J. / How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease : Development of a Clinical Decision Support Tool using a Delphi design. In: BMC Medicine. 2015 ; Vol. 13.

Bibtex Download

@article{7e4b64bae6ab42d6aa29dedb2347368e,
title = "How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease: Development of a Clinical Decision Support Tool using a Delphi design",
abstract = "Background: Clinicians request guidance to aid the routine use and interpretation of Patient Reported Outcome Measures (PROMs), but tools are lacking. We aimed to develop a Clinical Decision Support Tool (CDST) focused on information needs, family anxiety, depression, and breathlessness (measured using the Palliative care Outcome Scale (POS)) and related PROM implementation guidance. Methods: We drafted recommendations based on findings from systematic literature searches. In a modified online Delphi study, 38 experts from 12 countries with different professional backgrounds, including four patient/carer representatives, were invited to rate the appropriateness of these recommendations for problems of varying severity in the CDST. The quality of evidence was added for each recommendation, and the final draft CDST reappraised by the experts. The accompanying implementation guidance was built on data from literature scoping with expert revision (n = 11 invited experts). Results: The systematic literature searches identified over 560 potential references, of which 43 met the inclusion criteria. Two Delphi rounds (response rate 66 {\%} and 62 {\%}; n = 25 and 23) found that good patient care, psychosocial support and empathy, and open communication were central to supporting patients and families affected by all POS concerns as a core requirement. Assessment was recommended for increasing problems (i.e. scores), followed by non-pharmacological interventions and for breathlessness and depression, pharmacological interventions. Accompanying PROM implementation guidance was built based on the 8-step International Society for Quality of Life Research framework, as revised by nine (response rate 82 {\%}) experts. Conclusions: This CDST provides a straightforward guide to help support clinical care and improve evidence-based outcomes for patients with progressive illness and their families, addressing four areas of clinical uncertainty. Recommendations should be used flexibly, alongside skilled individual clinical assessment and knowledge, taking into account patients' and families' individual preferences, circumstances, and resources. The CDST is provided with accompanying implementation guidance to facilitate PROM use and is ready for further development and evaluation.",
keywords = "Clinical decision support tools, Delphi studies, Implementation, Palliative care, Palliative care outcome scale (POS), Patient reported outcome measures",
author = "{van Vliet}, {Liesbeth M.} and Richard Harding and Claudia Bausewein and Sheila Payne and Higginson, {Irene J.}",
year = "2015",
month = "10",
day = "13",
doi = "10.1186/s12916-015-0449-6",
language = "English",
volume = "13",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BIOMED CENTRAL LTD",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - How should we manage information needs, family anxiety, depression, and breathlessness for those affected by advanced disease

T2 - Development of a Clinical Decision Support Tool using a Delphi design

AU - van Vliet, Liesbeth M.

AU - Harding, Richard

AU - Bausewein, Claudia

AU - Payne, Sheila

AU - Higginson, Irene J.

PY - 2015/10/13

Y1 - 2015/10/13

N2 - Background: Clinicians request guidance to aid the routine use and interpretation of Patient Reported Outcome Measures (PROMs), but tools are lacking. We aimed to develop a Clinical Decision Support Tool (CDST) focused on information needs, family anxiety, depression, and breathlessness (measured using the Palliative care Outcome Scale (POS)) and related PROM implementation guidance. Methods: We drafted recommendations based on findings from systematic literature searches. In a modified online Delphi study, 38 experts from 12 countries with different professional backgrounds, including four patient/carer representatives, were invited to rate the appropriateness of these recommendations for problems of varying severity in the CDST. The quality of evidence was added for each recommendation, and the final draft CDST reappraised by the experts. The accompanying implementation guidance was built on data from literature scoping with expert revision (n = 11 invited experts). Results: The systematic literature searches identified over 560 potential references, of which 43 met the inclusion criteria. Two Delphi rounds (response rate 66 % and 62 %; n = 25 and 23) found that good patient care, psychosocial support and empathy, and open communication were central to supporting patients and families affected by all POS concerns as a core requirement. Assessment was recommended for increasing problems (i.e. scores), followed by non-pharmacological interventions and for breathlessness and depression, pharmacological interventions. Accompanying PROM implementation guidance was built based on the 8-step International Society for Quality of Life Research framework, as revised by nine (response rate 82 %) experts. Conclusions: This CDST provides a straightforward guide to help support clinical care and improve evidence-based outcomes for patients with progressive illness and their families, addressing four areas of clinical uncertainty. Recommendations should be used flexibly, alongside skilled individual clinical assessment and knowledge, taking into account patients' and families' individual preferences, circumstances, and resources. The CDST is provided with accompanying implementation guidance to facilitate PROM use and is ready for further development and evaluation.

AB - Background: Clinicians request guidance to aid the routine use and interpretation of Patient Reported Outcome Measures (PROMs), but tools are lacking. We aimed to develop a Clinical Decision Support Tool (CDST) focused on information needs, family anxiety, depression, and breathlessness (measured using the Palliative care Outcome Scale (POS)) and related PROM implementation guidance. Methods: We drafted recommendations based on findings from systematic literature searches. In a modified online Delphi study, 38 experts from 12 countries with different professional backgrounds, including four patient/carer representatives, were invited to rate the appropriateness of these recommendations for problems of varying severity in the CDST. The quality of evidence was added for each recommendation, and the final draft CDST reappraised by the experts. The accompanying implementation guidance was built on data from literature scoping with expert revision (n = 11 invited experts). Results: The systematic literature searches identified over 560 potential references, of which 43 met the inclusion criteria. Two Delphi rounds (response rate 66 % and 62 %; n = 25 and 23) found that good patient care, psychosocial support and empathy, and open communication were central to supporting patients and families affected by all POS concerns as a core requirement. Assessment was recommended for increasing problems (i.e. scores), followed by non-pharmacological interventions and for breathlessness and depression, pharmacological interventions. Accompanying PROM implementation guidance was built based on the 8-step International Society for Quality of Life Research framework, as revised by nine (response rate 82 %) experts. Conclusions: This CDST provides a straightforward guide to help support clinical care and improve evidence-based outcomes for patients with progressive illness and their families, addressing four areas of clinical uncertainty. Recommendations should be used flexibly, alongside skilled individual clinical assessment and knowledge, taking into account patients' and families' individual preferences, circumstances, and resources. The CDST is provided with accompanying implementation guidance to facilitate PROM use and is ready for further development and evaluation.

KW - Clinical decision support tools

KW - Delphi studies

KW - Implementation

KW - Palliative care

KW - Palliative care outcome scale (POS)

KW - Patient reported outcome measures

UR - http://www.scopus.com/inward/record.url?scp=84945206456&partnerID=8YFLogxK

U2 - 10.1186/s12916-015-0449-6

DO - 10.1186/s12916-015-0449-6

M3 - Article

AN - SCOPUS:84945206456

VL - 13

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

M1 - 263

ER -

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