Article Text
Abstract
Introduction Little is known about the use of outcome measures (OM) by Speech and Language Therapists (SLTs) in palliative care. This review aimed to identify studies using validated OMs in adults receiving palliative care, and to understand whether the OMs captured the impact of SLT interventions.
Methods The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines were used. 422 items were screened, 308 met the inclusion and exclusion criteria and seven papers were selected for review.
Results The papers described 296 patients. (range of 1 – 96 participants per study), aged 19 – 89 years, diagnosed with cancer (83), motor neurone disease (4), other/mixed (208), progressive neurological (1) and not further described (2). The heterogeneity of the study designs did not allow for further analysis. The studies were of poor quality.
Ten outcome measures were used in the studies. Assessment at two time points were described in 14 patients (two studies).
Conclusion OMs commonly used in palliative care do not address the main areas of clinical focus of SLTs; dysphagia and communication barriers. OMs used in SLT practice are rarely validated in palliative populations. Challenges are compounded by the reality of practice in the UK where SLTs offer consultation for palliative care patients but are infrequently employed within palliative care teams. Contact with patients may be a single assessment and advice session, reducing the opportunity to use OMs and demonstrate the efficacy of SLT colleagues. Evidence of change in response to SLT intervention is not yet demonstrated in the literature. Use of validated OMs by SLTs in palliative care appears to lag behind use of OMs in other areas of SLT work, and behind use of OMs by other professionals in palliative care. Development and use of validated OMs should consider flexibility as patient function changes and the need for both patient and proxy completion.