The use of The Palliative Outcome Scale (POS) in assessing Amyotrophic Lateral Sclerosis patients for identifying care intervention

Background: The Palliative Outcome Scale (POS) is an outcome measurement tool which is used to assess patients’ change in health over time. Early integration of palliative care measures into management of Amyotrophic Lateral... [ view full abstract ]

Background: The Palliative Outcome Scale (POS) is an outcome measurement tool which is used to assess patients’ change in health over time. Early integration of palliative care measures into management of Amyotrophic Lateral Sclerosis (ALS) has been shown to not only provide better symptom management but also improve quality of life. Currently in the Republic of Ireland, no set framework or defined triggers are in place for the initiation of palliative care in ALS patients. Utilisation of POS can help identify triggers for palliative care intervention and also help improve the management of the terminal phase of ALS.

Aims and Objectives: This study aims to determine whether the setting at which POS is assessed (home setting or in a professional environment) affects patient’s palliative care outcome scores. We also analysed whether ALS subtype (bulbar onset or spinal onset) or patient gender influenced POS score.

Methods: POS questionnaires were administered to 100 ALS patients who attended the National ALS clinic between January 2013 to September 2015, statistical analysis was carried out. POS assessments were conducted in two settings at three time point intervals, either in the patient’s home by a neuropsychology researcher or in the outpatient clinic by a senior neurology registrar at the author’s institution. Ethical approval was obtained from the author’s institution.

Findings: Home assessed POS scores were notably higher than clinic assessed (p> 0.001). A positive correlation was found between POS scores and disease progression. No significant differences were found on analysis of ALS subtype or gender.

Conclusion: Utilisation of POS in palliative care assessment in ALS can prove useful in highlighting changes in patients' needs and essentially triggers for care interventions.