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Introduction The Support Needs Approach for Patients (SNAP) is a complex intervention to facilitate delivery of person-centred care in progressive conditions, such as chronic obstructive pulmonary disease (COPD). SNAP consists of: The SNAP tool: designed for purpose (Gardener, Ewing, & Farquhar, 2019; Gardener, Ewing, Kuhn & Farquhar, 2018; Gardener, Ewing & Farquhar, 2018) comprising 15 evidence–based validated questions to help patients consider areas where they may need more support; The SNAP approach: a needs–led conversation between the patient and healthcare professional (HCP) to express, prioritise and address unmet support needs identified through the patient–completed tool. Feasibility and acceptability of the SNAP intervention now needs exploring in clinical practice. Methods HCPs from three care settings (primary, community and secondary) were recruited to the SNAP pilot in the East of England. SNAP-trained HCPs implemented SNAP with patients with COPD (n=56) over a four month period and participated in monthly qualitative interviews to monitor tool use and identify modifiable barriers to SNAP delivery. Purposively sampled patients (n=20) who received the intervention were interviewed about their experience. End of pilot focus groups with participating HCPs explored barriers and facilitators to delivering SNAP in clinical practice. Normalisation Process Theory (May & Finch, 2009) guided data collection and analysis. Results SNAP was considered acceptable and feasible by HCPs and acceptable to patients with COPD, with some variation by setting. This variation may relate to the nature of the setting and/or HCP investment in SNAP which may compromise intervention fidelity. HCPs identified three challenges for implementation: 1) limited consultation time, 2) delivering SNAP to non-English speakers, and 3) belief amongst some HCPs that they ‘already do this.’ SNAP enabled new needs-led conversations (including future care conversations) and consequent actions, even where patient-HCP relationships were well-established. Conclusion SNAP appears acceptable and feasible for use in practice with potential benefits to patients with COPD across a range of care settings. Findings are informing SNAP training refinement and indicate that formal evaluation of SNAP is warranted. |
