TY - JOUR
T1 - Impact of a half-day multidisciplinary symptom control and palliative care outpatient clinic in a comprehensive cancer center on recommendations, symptom intensity, and patient satisfaction
T2 - A retrospective descriptive study
AU - Strasser, Florian
AU - Sweeney, Catherine
AU - Willey, Jie
AU - Benisch-Tolley, Susanne
AU - Palmer, J. Lynn
AU - Bruera, Eduardo
N1 - Funding Information:
Florian Strasser, MD, is supported by a grant from Swiss Cancer Research (BIL grant KFS 950-09-1999).
PY - 2004/6
Y1 - 2004/6
N2 - To characterize a new, one-stop multidisciplinary palliative care (MD) clinic which offers standardized multidisciplinary assessment, specific care recommendations, patient and family education, and on-site counseling, we retrospectively compared the assessments of 138 consecutive patients with advanced cancer referred to the MD clinic and 77 patients referred to a traditional pain and symptom management (PSM) clinic. The two groups were similar in tumor type, demographics, and symptom distress. The MD clinic team (physicians; nurses; pharmacists; physical, speech, and occupational therapists; social workers; chaplains; nutritionists; psychiatric nurse practitioner) delivered 1,066 non-physician recommendations (median 4 per patient, range 0-37). The PSM clinic team made no non-physician recommendations, but referred 14 patients to other medical specialists. In 80 (58%) MD-clinic patients with follow-up 9 days (median) after assessment, significant improvement was observed in pain, nausea, depression, anxiety, sleep, dyspnea, and well-being, but not in fatigue, anorexia, or drowsiness. In 83 patients interviewed after the MD clinic, satisfaction was rated as excellent (5 out of 5) in 86-97% of seven areas. Assessment at an MD clinic results in a high number of patient care recommendations, improved symptoms, and high levels of patient satisfaction.
AB - To characterize a new, one-stop multidisciplinary palliative care (MD) clinic which offers standardized multidisciplinary assessment, specific care recommendations, patient and family education, and on-site counseling, we retrospectively compared the assessments of 138 consecutive patients with advanced cancer referred to the MD clinic and 77 patients referred to a traditional pain and symptom management (PSM) clinic. The two groups were similar in tumor type, demographics, and symptom distress. The MD clinic team (physicians; nurses; pharmacists; physical, speech, and occupational therapists; social workers; chaplains; nutritionists; psychiatric nurse practitioner) delivered 1,066 non-physician recommendations (median 4 per patient, range 0-37). The PSM clinic team made no non-physician recommendations, but referred 14 patients to other medical specialists. In 80 (58%) MD-clinic patients with follow-up 9 days (median) after assessment, significant improvement was observed in pain, nausea, depression, anxiety, sleep, dyspnea, and well-being, but not in fatigue, anorexia, or drowsiness. In 83 patients interviewed after the MD clinic, satisfaction was rated as excellent (5 out of 5) in 86-97% of seven areas. Assessment at an MD clinic results in a high number of patient care recommendations, improved symptoms, and high levels of patient satisfaction.
KW - Cancer care facilities
KW - clinical competence
KW - delivery of health care
KW - pain clinics
KW - professional-patient relations
UR - http://www.scopus.com/inward/record.url?scp=2542453697&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=2542453697&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2003.10.011
DO - 10.1016/j.jpainsymman.2003.10.011
M3 - Article
C2 - 15165646
AN - SCOPUS:2542453697
SN - 0885-3924
VL - 27
SP - 481
EP - 491
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 6
ER -