PD733 - CLINICIAN PERSPECTIVES ON DESIGN CONSIDERATIONS FOR EQUITABLE PROVISION OF PALLIATIVE PARENTERAL NUTRITION IN THE UK

PD733

CLINICIAN PERSPECTIVES ON DESIGN CONSIDERATIONS FOR EQUITABLE PROVISION OF PALLIATIVE PARENTERAL NUTRITION IN THE UK

J. Baker^1,*, A. J. Gifford¹, S. J. White¹

¹School of Allied Health Professions and Pharmacy, Keele University, Keele, United Kingdom

Rationale: The equitable provision of palliative parenteral nutrition (PPN) for advanced cancer patients with intestinal failure is a complex challenge within the UK's NHS. This study investigated clinician perspectives on essential design considerations for equitable PPN service provision. 

Methods: This qualitative study interviewed 30 healthcare professionals from gastroenterology, colorectal surgery, oncology, and palliative medicine specialties across North-West England NHS organisations. Ethical and Health Research Authority approvals were obtained. Interviews (April-December 2023) explored perceived barriers to home PPN and considerations for equitable service design. Transcripts were analysed using the Framework Method¹, guided by Normalisation Process Theory². 

Results: Five key themes emerged across NPT domains. Clinicians talked about PPN as potentially valuable for advanced cancer patients with intestinal failure. However, they identified numerous factors for implementation, including benchmarking existing PN services, the crucial role of nutrition support teams, and integrating nutritional assessment into professional curricula. Participants also stressed the importance of thorough patient counselling and selection. 

Image:

Conclusion: Providing equitable PPN in the UK requires addressing systemic and educational factors. Clinicians highlighted the promise of PPN for advanced cancer patients, but significant prerequisites for successful implementation. Key actions include service standardisation, strengthening nutrition support, enhancing professional education, and refining patient selection.

References:         1. Gale NK, et al. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.

        2. May CR, et al. Development of a theory of implementation and integration: Normalization Process Theory. Implementation Science. 2009;4(1):29. 

Disclosure of Interest: None declared