Table 2 Interviewees’ perceptions of their individual hospice data

The proportion of patients prescribed corticosteroids across the six hospices (range: 61% to 69%)

The interviewees were mostly surprised where their relative corticosteroid usage lay:

“Interesting. I would not have put us as great steroid users… we are leading the ranks on this study.” (M1)

“I thought probably the use in our [hospice name] was quite high and it is lower than the other hospices so that surprises me.” (M4)

“I think that is very representative.” (M5)

“I was a little surprised it [the range] was so narrow.” (N3)

The proportion of corticosteroids prescribed for non-specific/general wellbeing indications (range: 33% to 61%)

All were surprised at the proportion of patients being prescribed corticosteroids for non-specific/general wellbeing indications and some went so far as to say they found it disappointing:

“I am surprised that general well being is so high.” (M12)

“45% for wellbeing. Well that is disappointing.” (M3)

The proportion of corticosteroid adverse effects not recorded. (range: 55% to 85%)

There was no surprise here but it was acknowledged that it was an issue some said they found upsetting:

“The ‘not recorded’ it is always an issue.” (M1)

“I was pretty upset with the not recorded.” (M5)

The method of stopping corticosteroids stopped abruptly - (range: 14% to 34%)

Disappointment was expressed over abrupt cessation of corticosteroids particularly when the patient had been on them for more than three weeks. The general feeling was surprise at the low numbers of patients who had had their corticosteroids reduced gradually:

“I was rather taken aback about the abrupt ceasing. That surprised me because that certainly will not be a conscious thing.” (M11)

“I am surprised that gradually is so small.” (M12)

The proportion of corticosteroids monitored and reviewed (range: 29% to 69%)

Surprise and disappointment were expressed at the low percentage of reviewed and monitored patients:

“I was surprised to see that only 57% of the patients were reviewed. I would have thought that it would have been higher than that.” (M4)

“It’s really the ownership of the steroid that’s the issue. We work with oncologists and everybody but the policing and appropriation of the steroid, that is where the system falters.” (M11)

“It doesn’t surprise me that there is a large amount where it has not been recorded. I don’t think that we are very good at recording.” (M2)