Introducing the Palliative Performance Scale to clinicians: the Grampian experience

Area of Science:

• Palliative Care Medicine
• Clinical Assessment Tools
• Health Services Research

Background:

• The Palliative Performance Scale (PPS) was implemented across NHS Grampian to aid in palliative patient care.
• Assessing the practicality and utility of the PPS in diverse clinical settings was crucial.

Purpose of the Study:

• To evaluate the practical utility of the Palliative Performance Scale (PPS) for clinicians managing palliative patients.
• To determine how effectively the PPS identifies disease progression and functional changes across various care settings.

Main Methods:

• A prospective audit was conducted across primary, secondary, and nursing home care settings.
• Demographic and assessment data were collected over three months, with patient follow-up at 12 months.
• Clinician feedback on the PPS usability was gathered post-data collection.

Main Results:

• The PPS was generally found to be easy to use and helpful in recognizing disease progression in cancer patients.
• The PPS was less effective in identifying subtle changes in patients with dementia or frailty.
• Lower initial PPS scores and falling PPS scores were associated with poorer prognosis and increased risk of death.

Conclusions:

• Clinicians perceive the PPS as a quick and useful tool for assessing functional changes in palliative patients.
• The PPS may not adequately capture functional changes in advanced dementia or frailty.
• Survival data derived from PPS requires cautious interpretation across different populations and settings; further research is needed for non-malignant conditions.