Supporting Deprescribing in Palliative Care v1.1.

  • Research type

    Research Study

  • Full title

    PONDER: supPOrting shared DEcision-making for depRescribing in palliative care

  • IRAS ID

    305394

  • Contact name

    Adam Todd

  • Contact email

    adam.todd@newcastle.ac.uk

  • Sponsor organisation

    Newcastle upon Tyne Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 2 months, 31 days

  • Research summary

    Palliative care is an approach that aims to control symptoms, and improve the quality of life of patients as well as
    their families. It is often needed when people have incurable conditions. Over 300,000 people in England need
    palliative care each year.

    When palliative care is needed, people are commonly prescribed lots of different medications, which is called
    ‘polypharmacy’. Polypharmacy increases the risk of developing side effects. Research also tells us that people in
    palliative care are often prescribed medications when the harms outweigh the benefits. This is a big problem
    because we also know people find taking lots of medications a burden.

    One potential solution to this problem is to think about ways to reduce or stop medication that is no longer doing
    any good or when the harms outweigh the benefits. This process is called deprescribing. In any deprescribing
    approach, it is important that people are supported to make decisions that are right for them – a process known as
    shared decision-making. Shared decision-making brings together the doctor’s expertise, and what the patient feels
    is best for them. However, even though we know the benefits of shared decision-making, some palliative care
    healthcare professionals are reluctant or find it hard to engage in this process.

    This is where our research comes in. Our plan is to develop a tool to help promote shared decision-making
    between people receiving palliative care, their family members, and healthcare professionals to facilitate possible
    deprescribing. The project has 3 phases: for phase 1, we will review scientific studies to see what sorts of tools
    have been used before; for phase 2, we will interview patients with experience of palliative care, their close friends
    or family members, and healthcare professionals to find out their key needs in shared decision-making. And finally,
    for phase 3, we will hold a series of workshops with patients, their family members, and healthcare professionals
    to discuss the findings from phases 1 and 2. In this phase, with everybody working together, we will design a tool
    to promote shared decision-making about possible deprescribing in palliative care that incorporates everybody’s
    opinions, wishes, and experiences.

    To develop this project, we have worked in partnership with people who have had experience of polypharmacy
    and deprescribing. We have also consulted with different healthcare professionals to ensure our work is relevant to
    people working in the NHS. Importantly, throughout the project there will be regular meetings between the
    research team and patient and public representatives, to make sure that the work asks the right questions and our
    findings are presented in a way which makes them accessible and useful to everyone interested in this project.

  • REC name

    West Midlands - South Birmingham Research Ethics Committee

  • REC reference

    22/WM/0065

  • Date of REC Opinion

    8 Apr 2022

  • REC opinion

    Further Information Favourable Opinion