From the Research
The Supportive and Palliative Care Indicators Tool (SPICT) is the most effective palliative care identification tool in primary care settings, excluding those specific to heart failure, due to its ability to provide clear clinical indicators across multiple conditions and its better performance in identifying patients in need of palliative care compared to other tools. The SPICT is a valuable tool for identifying patients who may benefit from palliative care approaches based on general decline, increasing care needs, and specific disease markers, including cancer, dementia, neurological diseases, and organ failures 1. Implementation of the SPICT involves regular patient reviews during routine appointments, documenting identified needs, initiating advance care planning discussions, and coordinating with multidisciplinary teams. Some key points to consider when using the SPICT include:
- The tool has been shown to have better performance in hospitals than in general practice settings, with a sensitivity of 79.8% vs 45.3% and a specificity of 59.1% vs 97.0% 1.
- The SPICT is more time-consuming to use than other tools, such as the Surprise Question, but its digital search can be performed more easily after initial use 2.
- The tool has been used to identify patients at risk of deteriorating and dying within 1 year, and its indicators have been shown to correlate with higher mortality rates at 6 and 12 months 3. Overall, the SPICT is a useful tool for primary care clinicians to identify patients who may benefit from palliative care approaches, and its implementation can help improve the quality of life and alignment of care with patient preferences.