Developing a Support Needs Approach for Patients (SNAP2) - Stages 2-3

  • Research type

    Research Study

  • Full title

    Accessing and delivering person-centred care in advanced non-cancer conditions: developing and piloting a Support Needs Approach for Patients (SNAP) with advanced COPD [Stages 2 & 3]

  • IRAS ID

    241645

  • Contact name

    Morag Farquhar

  • Contact email

    M.Farquhar@uea.ac.uk

  • Sponsor organisation

    University of East Anglia

  • Clinicaltrials.gov Identifier

    ISRCTN29580717, ISRCTN registration

  • Duration of Study in the UK

    1 years, 5 months, 31 days

  • Research summary

    Summary of Research

    Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung condition that shortens people’s lives. People with advanced COPD have severe breathlessness and face difficulties in daily living. We know that patients have unmet care and support needs in advanced COPD. We also know some reasons why. Patients’ contacts with the health care professionals (HCPs) are often brief and tend to focus on problems such as lung infections: they rarely provide opportunities for patients to identify and discuss their support needs. Even when there is time patients are uncertain what they can ask about. HCPs cannot rely on patients telling them their concerns unless it is a time of crisis.

    If HCPs gave patients a brief tool to complete (a set of questions to consider), it might act as a prompt to help patients identify and express their support needs. The patient-completed tool could then be used by HCPs to start a conversation with the patient about their needs, and how they might be met. This new approach to identifying and addressing patient support needs is called the “Support Needs Approach for Patients” (SNAP). A similar approach, using a tool, has been developed for informal carers and is being successfully used in clinical practice nationally and internationally.

    We developed the patient SNAP tool with patients with advanced COPD, their informal carers and HCPs. However, SNAP is more than a tool: SNAP is the tool plus the conversation that follows between the patient and HCP to prioritise and address the support needs identified. As a new approach to patient care and support we need to find out how SNAP might work in a range of clinical settings and how to train HCPs to use it. We will also identify what we should measure in a larger study to test SNAP in clinical practice.

    Summary of Results

    The SNAP2 Study aimed to check (validate) and try out (pilot) the SNAP intervention for patients with advanced Chronic Obstructive Pulmonary Disease (COPD) – a chronic lung condition. SNAP (the Support Needs Approach for Patients) is a health care intervention designed to enable patient’s support needs to be met. It consists of the SNAP Tool (a set of 15 questions to help patients consider their support needs), and a needs-led conversation with their healthcare professional about those needs and how they might be met.

    The SNAP Tool was found to be valid for identifying the support needs of patients with advanced COPD. Unexpectedly, healthcare professionals, patients and their unpaid carers (family/friends who support them) told us the tool was also relevant to patients with other health conditions that are long-term or gradually worsening.

    We developed SNAP training for healthcare professionals (now freely available on the SNAP website: https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbVs63yvfJSFk-2BtZ1QmjoB-2BG-2BeFCKALGzUrIDS6W44-2BARwC_W_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YK5CYSHNpj3QzdN3-2Fad0dMEygDwAKqeKBLJw9ERI6onfNCKdYWh6Retme6-2Bc2CEXzk6MYENFWI5trZ-2BcfTVl7xES5p1xTS49d5XyDQKrz9VQbVAQhgqcu-2BOwNgu1YXT4U2GEmLclMcgKsmUG36gWYFeqs7L7TkjOnnrUiQGihi4fg-3D-3D&data=05%7C01%7Capprovals%40hra.nhs.uk%7C2e9c01d190ae4b2bbdb308dadf94c118%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638068127230974860%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=%2BylKIytdWI%2Bo85KZTO2JGdUeY%2BCXb6R7D6t0xmkluOY%3D&reserved=0 then successfully piloted SNAP in three different types of clinical setting: GP surgeries, community and hospital. We learned from patients who experienced SNAP, and the healthcare professionals who delivered it, how it works best.

    We also carried out work for a larger study to fully test SNAP in clinical practice. We held a stakeholder workshop to identify possible outcomes we could measure in it. The findings were then combined with the views of patients from the SNAP pilot, our Patient and Carer Advisory Group and Study Advisory Group, and then used in an online survey to capture the views of a wider range of healthcare professionals.

    SNAP is now being used internationally: the SNAP Tool has been translated into Swedish and Chinese (traditional), and is being translated into Portuguese.

  • REC name

    North West - Preston Research Ethics Committee

  • REC reference

    18/NW/0234

  • Date of REC Opinion

    8 May 2018

  • REC opinion

    Further Information Favourable Opinion