PP-1 Towards a stakeholder-informed understanding of unmet palliative care needs: Findings from a scoping review and stakeholder workshops

Background Identifying and quantifying unmet palliative care needs at a population level is important for service planning and provision, but consensus on definition and measurement is lacking. Aims To review how unmet palliative care needs have been defined, measured and reported in the literature, and explore how people with lived and professional experience conceptualise and prioritise unmet needs. Methods As part of the Marie Curie-funded DUE-Care project, we conducted a scoping review, followed by stakeholder workshops and ranking exercise with people with lived and professional experience using a modified nominal group technique. Review data were charted and summarised narratively using inductive content analysis and framework synthesis. Findings informed the workshop discussions, which were analysed using content analysis, with the stakeholder ranking analysed descriptively. Results The review included 70 studies, of which 11 (16%) provided an explicit definition of unmet palliative care needs. We identified three approaches to measure unmet palliative care needs: symptoms and concerns; access to palliative services; and sufficiency of service provision to resolve symptoms and concerns. Workshop participants (n=28) identified and refined 27 elements of unmet palliative care needs, before ranking them. Highly prioritised elements included lack of timely and holistic assessment, inability to access services, and lack of coordination and continuity of care. Relational aspects, such as dignity and empathy, were also emphasised. Conclusion This research highlights conceptual and methodological gaps in the literature. The three approaches to measurement highlight different but complementary aspects of capturing unmet palliative care needs. Our findings provide a first step for developing stakeholder-informed approaches to assess unmet needs. Impact This work draws on multiple perspectives to develop understanding and measurement of unmet palliative care needs at a population level.