Article Text

PDF
Introducing the Palliative Performance Scale to clinicians: the Grampian experience
  1. Gordon Linklater1,
  2. Sally Lawton1,
  3. Shona Fielding2,
  4. Lisa Macaulay1,
  5. David Carroll1 and
  6. Dong Pang3
  1. 1Department of Palliative Medicine, NHS Grampian, Aberdeen, UK
  2. 2Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
  3. 3Institute of Health Research, University of Bedfordshire, Luton, UK
  1. Correspondence to Gordon Linklater, Palliative Medicine, NHS Grampian, Roxburghe House, Ashgrove Road, Aberdeen AB25 2ZH, UK; g.linklater{at}nhs.net

Abstract

Objectives The Palliative Performance Scale (PPS) was introduced across NHS Grampian. Our aim was to determine how practical and useful the PPS was for clinicians looking after palliative patients in a variety of settings.

Methods A prospective audit approach was used in primary, secondary and nursing home care settings who. Demographic and assessment data were gathered for 3 months; feedback was gathered at the end of the data collection phase. Patient follow-up status was determined at 12 months.

Results Fifteen clinical sites participated and feedback was obtained from all clinical areas (n=30). Most respondents found the PPS easy to use and that it helped recognise disease progression in cancer patients, but not in patients with dementia/frailty. Assessment data were gathered on 666 patients. Sixty per cent had a malignant diagnosis and 62.5% of the sample died within 12 months. Lower PPS scores at initial assessment indicated poorer prognosis. Median survival figures differed from previously published data. Falling PPS scores increased the risk of death compared with patients whose PPS scores remained static or improved.

Conclusion Clinicians found the PPS to be a quick, useful way of assessing and reviewing functional changes in palliative patients. However, it may not identify the subtle changes in individuals with advanced dementia. The survival figures confirm that caution is needed in generalising survival data across different settings and populations. Further work is needed to examine changing functional status in patients with non-malignant diseases or dementia/frailty.

  • Received 27 September 2011.
  • Accepted 9 February 2012.

Statistics from Altmetric.com

  • Received 27 September 2011.
  • Accepted 9 February 2012.
View Full Text

Footnotes

  • Funding Friends of Roxburghe House charity.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.