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Quality of Life and Home Parenteral Nutrition: A Survey of UK Healthcare Professionals' Knowledge, Practice and Opinions.

INTRODUCTION
There is increasing interest in the assessment of health-related quality of life (QoL) in the care of patients treated with home parenteral nutrition (HPN). However, it is not known whether healthcare professionals (HCPs) have embedded QoL assessment into routine clinical practice in line with current guidelines, and to favour a more holistic approach to HPN care. The aim of this study was to assess knowledge, current practice, and the opinions of HCPs regarding QoL in care of patients on HPN.


METHOD
An online survey was distributed via email to HCPs working with HPN patients throughout England, Scotland, Wales and Northern Ireland. Participants were identified using a mailing list for the British Intestinal Failure Alliance; a specialist group within the British Association for Parenteral and Enteral Nutrition.


RESULTS
The survey was completed by 67 professionals including 24 dietitians, 17 nurses, 14 gastroenterologists, 6 pharmacists, 5 surgeons and 1 psychologist. Of these, 54 (80%) participants agreed that the measurement of QoL is useful. In contrast, 38 (57%) of all participants, including 27 (50%) of those participants that agreed the measurement of QoL was useful, never measure QoL. Knowledge of QoL literature was rated as poor or very poor by 27 (40%) participants.


CONCLUSION
Despite the perceived usefulness and importance of QoL assessment, very few HCPs are embedding it into clinical practice. Knowledge of QoL literature and QoL tools is variable and there is significant variability in QoL practice. This is clear in terms of the frequency of QoL assessments, and heterogeneity in methodology. In contrast, there was almost unanimous agreement that the complications associated with HPN contribute to poorer QoL. There is a need for specific, evidence-based, clinical practice guidelines detailing how to define and measure QoL in this patient population. This article is protected by copyright. All rights reserved.