'Prompt' Tool Usability

• Research type

  Research Study

• Full title

  Validating the usability of the 'Prompt' tool for decision-making support by community matrons (and allied team) when proactively planning care for frail elderly patients in the community.

• IRAS ID

  320350

• Contact name

  Cath Jenson

• Contact email

  cathjenson@nhs.net

• Sponsor organisation

  Bromley Healthcare

• Clinicaltrials.gov Identifier

  n/a, n/a

• Duration of Study in the UK

  0 years, 3 months, 26 days

• Research summary

  Older people generally decline in health as they approach the end of their life. This can result in clinical ‘interventions’ that have little impact on life expectancy but make the final years more uncomfortable. They also consume scarce nhs resources.

  There are 3 'headline' problems this research seeks to tackle:
  - Supporting clinicians to synthesise a complex dataset around ‘declining potential for cure’
  - Prompting clinicians to open discussions with patients about future ('anticipatory') care
  - Allowing nhs resources to be appropriately targeted and patients more involved/satisfied with care.

  Various attempts have been made to tackle the problems listed above by developing predictive 'risk' tools that weight coded diagnoses, prescriptions and diagnostic test results to create a ‘score’. To date, none have been able to demonstrate positive outcomes for patients.

  This research is different in creating a weighting system based on function/disability rather than diagnosis. This is important because:
  • Not all diagnosis are coded – if they are, often the code does not relate to the impact on disability or prognosis
  • Coding often weights patient engagement (e.g. willingness to have tests) rather than clinical need.

  The dataset of 8000 patients has been anonymised, segmented using clinical judgement (‘GP brain’) and submitted to AI weighting to create a ‘fingerprint’ of likelihood to be entering last year of life.

  The aim is to find out the usability of the tool by clinicians, who will be asked a series of questions to ascertain if the tool successfully supported decision-making. The measurable endpoints for impact will include patient satisfaction/wellbeing, long-term condition/symptom control and avoidance of unscheduled care/adverse outcomes.

• REC name

  Yorkshire & The Humber - Bradford Leeds Research Ethics Committee

• REC reference

  23/YH/0165

• Date of REC Opinion

  27 Jul 2023

• REC opinion

  Unfavourable Opinion