Designing a patient-centered Strategy using an Individualised Holistic Needs Assessment Tool for Palliative Care in Colombia

Introduction: Palliative care (PC) in Colombia has made remarkable progress in the last decade. However, barriers to access, fragmentation of the health system, shortages in supply, and accurate identification of who requires what type of services persist. To address these issues, the SPARC-Sp (Sheffield Profile for Assessment and Referral to Care validated in Colombian Spanish) instrument performs a holistic assessment of these needs. Despite of its benefits. To date, it has not been implemented in Colombia.

Objectives: Co-design a strategy to emphasize the importance of holistic needs assessment in PC and disseminate SPARC-Sp implementation in all care settings in Colombia.

Methodology: A series of eight co-design workshops were conducted in 2022/2023, four online and four face-to-face in rural and urban areas of Colombia. A qualitative methodology was used under a constructivist paradigm, led by a team in the UK (Queen's University Belfast and University of Sheffield) and Colombia (Universidad del Cauca and Pontificia Universidad Javeriana). Participants were recruited through social networks and organizations of patients, carers, healthcare professionals, volunteers, non-governmental organizations, administrative and financial staff, and decision-makers. The information was analyzed using an iterative approach in the field to identify the main categories that were input to co-design the implementation and dissemination of SPARC-Sp in Colombia.

Results: The workshops explored the current situation of Colombian PC. Categories such as education, demystification, and actors involved in the implementation of PCs were identified, as well as the dissemination of SPARC-Sp, perceived as a useful tool to initiate conversations on PC and identify holistic needs in this area. However, its adaptation is necessary considering the low educational level of the population and the particularities of the health system. In response to these findings, we propose adaptations to SPARC-Sp and co-design a series of five videos aimed at health professionals, patients, and families to strengthen education in the area of holistic needs in PC and build a strategy for the implementation of SPARC-Sp.

Conclusions: This project co-designed an audiovisual strategy to educate about PCs in Colombia and adapt aspects of the SPARC-Sp application that allow for the identification and assessment of holistic needs favoring the integration of patients, caregivers, and health professionals in the timely provision of associated care.