Question 1

Does a positive SPICT mean the patient is terminally ill?

Accepted Answer

No — SPICT identifies patients with deteriorating health and potential unmet palliative needs, not imminently terminal patients. Many patients flagged by SPICT continue disease-modifying therapy alongside a palliative approach. The goal is earlier integration of palliative care, not cessation of active treatment.

Question 2

What is the evidence that SPICT improves outcomes?

Accepted Answer

Implementation studies show that SPICT increases palliative care referral rates 2–3 fold, reduces unplanned hospital admissions, improves advance care planning documentation, and increases the proportion of patients dying in their preferred place of care. It is associated with better symptom control and family satisfaction.

Question 3

Can SPICT be used in primary care?

Accepted Answer

Yes — SPICT was specifically developed for use across all care settings including primary care. A practice-level register of SPICT-positive patients enables proactive, anticipatory care planning, and case management. Many general practice electronic health record systems support SPICT integration with coded data entry.

Question 4

How often should SPICT screening be repeated?

Accepted Answer

For stable patients with life-limiting illness, annual screening is appropriate. For patients with progressive decline, repeated screening every 3–6 months or at each significant health event (hospitalisation, new diagnosis, functional decline) is recommended. Re-screening detects deterioration and evolving palliative needs.