Research project: Self-Management of analgesia and related treatments at the end of life (SMARTE)

We aim to develop a support tool to improve the management of medications for pain relief, nausea, constipation and drowsiness in patients with significant pain approaching the end of life. Our self- management support tool (SMST) will be developed using a patient centred approach and will be delivered in partnership with health care professionals (HCPs) in two UK regions. We have embedded the principles of experience based co-design into the development, modelling and testing of our
prototype SMST, within a theoretical framework for characterising and designing behaviour change interventions.  Ultimately we aim to establish the acceptability and uptake of our prototype SMST and determine the feasibility of evaluating this intervention within a definitive RCT.
Our objectives are divided into three distinct phases which is in-line with the MRC framework on developing and evaluating complex interventions and normalisation process theory.

Development objectives (Phase I)

• Establish a PPI panel
• Establish the content of a prototype SMST and a manualisation strategy that includes a protocol to standardise (i) the training of HCP and (ii) the delivery of the intervention by HPCs to patients and carers
• Understand self-management needs and capabilities of patients and carers.
• Define usual care

Modelling objectives (Phase II)

• Refine and co-design the prototype SMST and manualisation

Feasibility assessment objectives (Phase III)

• Assess acceptability and up-take of the SMST in a mixed-methods observational study involving patients, informal carers and HCPs from 4 palliative care services
• Assess the feasibility of obtaining outcome data for a larger trial

Funder

NIHR Health Technology Assessment Programme

NIHR project page

Host institution Leeds Institute of Health Sciences, University of Leeds

PI Professor Mike Bennett University of Leeds

Leeds Project page

Research team

Dr Matt Mulvey, University of Leeds

Prof Jose Closs, University of Leeds

Hilary Bekker, University of Leeds

Mr David Meads, University of Leeds

Prof Alison Blenkinsopp, University of Bradford

Dr Kate Flemming, University of York

Prof Sue Latter, University of Southampton

Prof Alison Richardson, University of Southampton

Dr Natasha Campling, University of Southampton

Mr Paul Carder West and South Yorkshire and

Bassettlaw Commissioning Support Unit

Prof Amanda Farrin, University of Leeds

Mrs Jean Gallager, PPI representative

Ms Rosie Ratcliff, St Gemma’s Hospice

Prof Stephen Morley, University of Leeds