Palliative care Outcome Scale (POS) - POS

POS - How to interpret

POS is designed to be responsive to change. It can detect clinically important changes over time that are related to the course of the disease or to an intervention, such as symptom management.

What patient says is important to them is a vital consideration when interpreting a POS score. Patients’ views can be gained through an informal discussion about the scores, and probes such as “Tell me more about what that score means to you”. Discussions with patients about their own priorities and what they perceive to be making a difference to them is helpful.

In clinical practice, patient-centred clinical reasoning should be used when interpreting POS scores. Clinical supervision and regular review of POS data aids patient-centred care.

Generally, individual POS item scores of zero or one require less clinical attention than items that score three or four. For example, if a patient scores a four for question one when rating their pain this means the patient is reporting pain that is overwhelming to them and hinders their ability to think of anything else. A score of zero indicates that the patient isn’t affected at all by pain, and a score of one means they are slightly impacted upon by pain but not bothered by it.

Changes in scores over time are important to detect as they may indicate disease progression or a change in perception, circumstances or priorities. For example, a pain score that changes from one to two may indicate that something has changed in the patient’s profile to the degree that it is now impacting on their activities. A timely clinical response is required when items are scored with a three or four, or when scores change.

Guidance on how to interpret and analyse outcome measurement data is available.

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