Use of the supportive and palliative care indicators tool (SPICT™) for end-of-life discussions: a scoping review

Background In order to mitigate the distress associated with life limiting conditions it is essential for all health professionals not just palliative care specialists to identify people with deteriorating health and unmet palliative care needs and to plan care. The SPICT (TM) tool was designed to assist with this.Aim The aim was to examine the impact of the SPICT (TM) on advance care planning conversations and the extent of its use in advance care planning for adults with chronic life-limiting illness.Methods In this scoping review records published between 2010 and 2024 reporting the use of the SPICT (TM), were included unless the study aim was to evaluate the tool for prognostication purposes. Databases searched were EBSCO Medline, PubMed, EBSCO CINAHL, APA Psych Info, ProQuest One Theses and Dissertations Global.Results From the search results 26 records were reviewed, including two systematic review, two theses and 22 primary research studies. Much of the research was derived from primary care settings. There was evidence that the SPICT (TM) assists conversations about advance care planning specifically discussion and documentation of advance care directives, resuscitation plans and preferred place of death. The SPICT (TM) is available in at least eight languages (many versions have been validated) and used in many countries.Conclusions Use of the SPICT (TM) appears to assist advance care planning. It has yet to be widely used in acute care settings and has had limited use in countries beyond Europe. There is a need for further research to validate the tool in different languages. What is already known on this topic?center dot The SPICT (TM) was developed to assist clinicians to screen patients for palliative care needs.What this review found.center dot The SPICT (TM) assists conversations about advance care planning and facilitates changes in documented goals of care.center dot The SPICT (TM) is available in at least eight languages (and used in many countries.How the findings of this review may affect practice and research.center dot Evidence suggests that formalising screening for palliative care needs using the SPICT (TM) is advantageous for advance care planning; clinicians should consider using the SPICT (TM) to initiate discussions with people with life limiting conditions.center dot Further research is required to validate the tool in different languages and extend its use in acute care settings and with other patient cohorts.