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Which outcome domains are important in palliative care and when? An international expert consensus workshop, using the nominal group technique

Research output: Contribution to journalArticlepeer-review

Susanne de Wolf-Linder, Marsha Dawkins, Francesca Wicks, Sophie Pask, Kathy Eagar, Catherine J Evans, Irene J Higginson, Fliss E M Murtagh

Original languageEnglish
Pages (from-to)1058-1068
Number of pages11
JournalPalliative Medicine
Issue number8
Early online date12 Jun 2019
Accepted/In press7 May 2019
E-pub ahead of print12 Jun 2019
Published1 Sep 2019


King's Authors


BACKGROUND: When capturing patient-level outcomes in palliative care, it is essential to identify which outcome domains are most important and focus efforts to capture these, in order to improve quality of care and minimise collection burden.

AIM: To determine which domains of palliative care are most important for measurement of outcomes, and the optimal time period over which these should be measured.

DESIGN: An international expert consensus workshop using nominal group technique. Data were analysed descriptively, and weighted according to ranking (1-5, lowest to highest priority) of domains. Participants' rationales for their choices were analysed thematically.

SETTING/PARTICIPANTS: In all, 33 clinicians and researchers working globally in palliative care outcome measurement participated. Two groups (n = 16; n = 17) answered one question each (either on domains or optimal timing). This workshop was conducted at the 9th World Research Congress of the European Association for Palliative Care in 2016.

RESULTS: Participants' years of experience in palliative care and in outcome measurement ranged from 10.9 to 14.7 years and 5.8 to 6.4 years, respectively. The mean scores (weighted by rank) for the top-ranked domains were 'overall wellbeing/quality of life' (2.75), 'pain' (2.06), and 'information needs/preferences' (2.06), respectively. The palliative measure 'Phase of Illness' was recommended as the preferred measure of time period over which the domains were measured.

CONCLUSION: The domains of 'overall wellbeing/quality of life', 'pain', and 'information needs/preferences' are recommended for regular measurement, assessed using 'Phase of Illness'. International adoption of these recommendations will help standardise approaches to improving the quality of palliative care.

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