169 Acceptability and experience of a new integrated oncology and palliative care ‘triggers’ service for cancer patients: a qualitative study

Abstract

Background Clinical trials demonstrate that early referral to specialist palliative care improves patient outcomes in terms of quality of life and symptom control. This qualitative research study is part of a mixed methods evaluation of a novel early integrated Palliative Care (‘Triggers’) service for cancer patients. The Triggers service involves the use of a palliative care referral ‘Triggers’ tool for healthcare professionals to proactively identify patients who should be referred to palliative care. Aims To explore the acceptability of the ‘Triggers’ service and experiences of early palliative care for healthcare professionals using this service. Methodology This study has extensive Patient and Public Involvement input and was approved by the hospital Committee for Clinical Research and the Research and Ethics Committee. Using the Grounded theory approach, qualitative in-depth semi-structured interviews were carried out with eleven healthcare professionals who work in the oncology outpatient clinics, where the ‘Triggers’ clinical service is taking place. Results The use of a palliative care referral ‘Triggers’ tool to underpin an early integrated palliative care service is acceptable. Emergent themes were: What’s in a name?–The effect of the name and its associated connotations with death and dying. A rose by any other name–Thoughts about changing to an alternate name. Timing is everything–Observations about the timing of the ‘Triggers’ service in clinic. All you need is more–Resource limitations and an ideal scenario of a joint approach to delivering care. Constantly redefining the future–Uncertainties about the future with new cancer treatments, associated symptoms and changing prognoses. Conclusion An early integrated palliative care service is acceptable to healthcare professionals. Considerations for future care include the benefits of re-marketing and defining the optimal time for introducing palliative care to oncology patients.