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Support Care Cancer. 2013 Nov;21(11):3031-7. doi: 10.1007/s00520-013-1838-z. Epub 2013 Jun 21.

Palliative and oncologic co-management: symptom management for outpatients with cancer.

Author information

1
Department of Medicine, University of California, San Francisco, 1849 Oak Street, Upper Unit, San Francisco, CA, 94117, USA, kara.bischoff@ucsf.edu.

Abstract

PURPOSE:

Although outpatient palliative care clinics are increasingly common, evidence for their efficacy remains limited.

METHODS:

We conducted an observational study at the palliative care clinic of an academic cancer center to assess the association between palliative care co-management and symptoms and quality of life. Two hundred sixty-six adult outpatients were seen for a minimum of two palliative care visits within 120 days. A subset of 142 patients was seen for a third visit within 240 days. Patients completed a questionnaire containing validated symptom, quality of life, and spiritual wellbeing questions at each visit.

RESULTS:

The first follow-up visit was on average 41 days after the initial visit; the second follow-up visit was on average 81 days after the initial visit. Between the initial and first follow-up visits, there was significant improvement in pain (p < 0.001), fatigue (p < 0.001), depression (p < 0.001), anxiety (p < 0.001), quality of life (p = 0.002), and spiritual wellbeing (p < 0.001), but not nausea (p = 0.14). For the subset of patients seen for a second follow-up visit, the improvements in pain, fatigue, depression, anxiety, quality of life, and spiritual wellbeing persisted (p ≤ 0.005 for trend of each symptom). Patients had similar improvement regardless of their gender, age, ethnicity, disease stage, disease progression, and concurrent oncologic treatments.

CONCLUSIONS:

Palliative care was associated with significant improvement in nearly all the symptoms evaluated. A sustained change in symptoms was observed in the subset of patients seen for a second follow-up visit. Members of all subgroups improved.

PMID:
23794100
DOI:
10.1007/s00520-013-1838-z
[Indexed for MEDLINE]

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