TY - JOUR
T1 - Impact of a palliative care consultation team on cancer-related symptoms in advanced cancer patients referred to an outpatient supportive care clinic
AU - Yennurajalingam, Sriram
AU - Urbauer, Diana L.
AU - Casper, Katie L.B.
AU - Reyes-Gibby, Cielito C.
AU - Chacko, Ray
AU - Poulter, Valerie
AU - Bruera, Eduardo
N1 - Funding Information:
Eduardo Bruera is supported in part by National Institutes of Health grants R01NR010162-01A1, R01CA1222292.01 , and R01CA124481-01 . Sriram Yennurajalingam is supported in part by American Cancer Society grant MRSG-07-001-01-CCE . The authors declare no conflicts of interest.
PY - 2011/1
Y1 - 2011/1
N2 - Context: Patients with advanced cancer may develop severe physical and psychosocial symptoms. There are limited data on the impact of an outpatient palliative consultation (PC) team on cancer-related symptoms. Objectives: To study the impact of the PC on symptoms in patients with advanced cancer receiving outpatient palliative care. Methods: Four hundred six consecutive patients referred to a supportive care outpatient center (OPC) from January 2006 to June 2007 with complete Edmonton Symptom Assessment Scale (0-10 scale) at the initial and follow-up visits were reviewed. Patient characteristics, change of symptoms at follow-up visit, and response rate were analyzed. Using logistic regression models, the predictors of improvement of pain and fatigue were assessed. Results: Median age was 59 years; 53% were female. Median interval between visits was 15 days. Mean scores at baseline and follow-up visits were fatigue 6.8 and 5.3 (P < 0.0001), pain 5.3 and 4.1 (P < 0.0001), depression 3.2 and 2.5 (P < 0.0001), anxiety 3.7 and 2.8 (P < 0.0001), dyspnea 2.7 and 2.5 (P = 0.05), sleep 5 and 4 (P < 0.0001), and well-being 5.2 and 4.4 (P < 0.0001). Dyspnea (odds ratio and P-value, 0.90, 0.03), nausea (0.92, 0.06), and depression (0.91, 0.04) were associated with improvement in fatigue; drowsiness (1.10, 0.04), and feeling of well-being (0.87, 0.02) were associated with improvement in pain. Conclusion: The initial consult by PC achieved significant symptom improvement in patients receiving treatment in the OPC. Further prospective studies are needed.
AB - Context: Patients with advanced cancer may develop severe physical and psychosocial symptoms. There are limited data on the impact of an outpatient palliative consultation (PC) team on cancer-related symptoms. Objectives: To study the impact of the PC on symptoms in patients with advanced cancer receiving outpatient palliative care. Methods: Four hundred six consecutive patients referred to a supportive care outpatient center (OPC) from January 2006 to June 2007 with complete Edmonton Symptom Assessment Scale (0-10 scale) at the initial and follow-up visits were reviewed. Patient characteristics, change of symptoms at follow-up visit, and response rate were analyzed. Using logistic regression models, the predictors of improvement of pain and fatigue were assessed. Results: Median age was 59 years; 53% were female. Median interval between visits was 15 days. Mean scores at baseline and follow-up visits were fatigue 6.8 and 5.3 (P < 0.0001), pain 5.3 and 4.1 (P < 0.0001), depression 3.2 and 2.5 (P < 0.0001), anxiety 3.7 and 2.8 (P < 0.0001), dyspnea 2.7 and 2.5 (P = 0.05), sleep 5 and 4 (P < 0.0001), and well-being 5.2 and 4.4 (P < 0.0001). Dyspnea (odds ratio and P-value, 0.90, 0.03), nausea (0.92, 0.06), and depression (0.91, 0.04) were associated with improvement in fatigue; drowsiness (1.10, 0.04), and feeling of well-being (0.87, 0.02) were associated with improvement in pain. Conclusion: The initial consult by PC achieved significant symptom improvement in patients receiving treatment in the OPC. Further prospective studies are needed.
KW - Symptom control
KW - interdisciplinary team
KW - palliative care
KW - symptom distress
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U2 - 10.1016/j.jpainsymman.2010.03.017
DO - 10.1016/j.jpainsymman.2010.03.017
M3 - Article
C2 - 20739141
AN - SCOPUS:78651314854
SN - 0885-3924
VL - 41
SP - 49
EP - 56
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 1
ER -