Identifying patients who could benefit from palliative care by making use of the general practice information system: the Surprise Question versus the SPICT

Many patients prefer to spend the last phase of their lives in the comfort of their own homes, thus it is important to identify patients who would benefit most from palliative care. Having said that, it is difficult for general practitioners (GPs) to identify such patients, giving rise to tools to assist GPs. This study compared the performance of two tools: the Surprise Question (SQ) and the Supportive and Palliative Care Indicators Tool (SPICT). The SQ asks, “Would you be surprised if the patient died within the next year?” If the GP’s answer is no, the provider is triggered to initiate primary palliative measures with the patient. Whereas the SPICT was translated into a digital search for a selection of symptoms and disease in the GP’s electronic records. Cancer was the disease most frequently found in all selections, indicating high demand for palliative care within cancer. To compare the tools’ ability to select patients who would benefit from palliative care, 1-year mortality after selection was used as an outcome measure. The sensitivity was 50% and 58%, and the specificity was 99% and 98% for SQ and SPICT, respectively. From the GP’s experience perspective, they found SPICT’s digital search time consuming, however, SPICT seems to be better at identifying patients in need of palliative care. These results suggest SPICT can be useful in identifying patients, such as cancer patients, in need of palliative care to help patients live life as fully and as comfortably as possible.

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