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CAPC Palliative Care Discussion Forum
Data Collection and Measurement
survey toolAuthor: ringram
Date: Feb 23, 2009 10:05 am
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Great question! I do not know of a specific tool that addresses this issue, but you could certainly create one. You can use a standard pain assessemnt tool to get at symptom burden, and supplement that with questions about medication adjustments. You might use the method we developed for our outpatient palliative care service - you can review the tool we developed by going to the "tools" section of the CAPC Web site, the link to our tool is
http://www.capc.org/tools-for-palliative-care-programs/clinical-tools/pain-symptom-assessment/physician-data-form.doc
Our outpatient providers note medication preseribing/adjustments for four classes of meds and then use a checkbox system to note if new meds were offered (declined or accepted or considered) and for existing medications if these were adjsuted or continued.
Hope that is helpful.
Regards, Kathleen Kerr, Senior Analyst, University of California San Francisco, Palliative Care Leadership Center