Development of a generic working definition of 'supportive care'

Context The term 'supportive care', despite everyday and widespread use, remains an ambiguous concept that lacks clarity. A generic definition would underpin the development of services and provide a basis for disease specific approaches to care. Objectives To develop a generic working definition of supportive care that could be applied to a range of diseases and chronic illnesses. Methods An indepth review of the literature was carried out to identify existing generic and disease specific definitions and descriptions of supportive care. Following the review, a modified two-phase Delphi study was performed. Participants included experts in the area of supportive care identified during the review in addition to charities or their representatives. A draft definition was developed based upon the outcome of the Delphi study. Results The literature review identified one brief generic definition of supportive care with no explanation of its origin. A further 17 disease specific definitions were identified, all relating to cancer. The review led to the development of 100 statements for inclusion in phase I of the modified Delphi study. 26 responses were received to phase I of the Delphi study and 17 responses to phase II. General agreement was received during the second stage and a final draft definition subsequently developed. Conclusions The resulting definition of supportive care might provide a basis for service development and could be further adapted to disease specific contexts. It would benefit from broader consultation to determine acceptability among a wider range of health professionals and service users.