Introduction The Integrated Palliative Care Outcome Scale (IPOS) offers potential to measure outcomes of palliative care interventions.¹ Antibiotics are commonly given for symptomatic relief in hospices but the evidence base is weak, supported typically from the perceived improvement in symptoms as judged by healthcare professionals.^2–5 IPOS adds the patient‘s voice to this debate.

Methods A retrospective notes review of 31 inpatients at 2 hospices in Northamptonshire from 20/17/19 to 20/11/19 receiving antibiotics was conducted. The pre and post antibiotic IPOS scores for pain, breathlessness, confusion and ‘other’ symptoms were analysed using a paired T test facilitated by SPSS V11.

Results The most common use of antibiotics was documented to control ‘other’ symptoms (n=16) not covered by IPOS. The most common ‘other’ symptom recorded were fever (n=7), but also included cough, incontinence and drowsiness.

Antibiotics caused an average reduction in the IPOS scores for pain of 0.45, CI 1.49 to -1.28 (p 0.11). Breathlessness reduced by 0.16 (CI 1.44 to -0.60, p 0.42). Confusion reduced by 0.26 (CI 1.13 to -0.78, p 0.17). Other symptoms improved by 0.65 (CI -0.11 to -1.18 p 0.02).

Conclusion Although some patients did report improvements, the findings of this audit suggest that antibiotics may not affect patients‘ IPOS reported symptoms. This prompts reflection on both the use of antibiotics and the implementation of IPOS in the hospices. The potential clinical and research implications of utilising IPOS to evaluate the effectiveness of specific palliative care interventions warrants further research.

References

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