Multidisciplinary symptom control clinic in a cancer center: a retrospective study.
Our objective in this study was to review the characteristics, symptom intensity and satisfaction of patients referred to a half-day symptom control clinic (SCC) for advanced cancer patients. This was a retrospective study. The setting was a multidisciplinary symptom control clinic in a cancer centre. Those taking part were 166 consecutive advanced cancer patients referred to the half-day multidisciplinary SCC because of symptom distress. Patients referred to the clinic were assessed in a private room by a physician, a nurse, a pharmacist, a psychologist, and social, rehabilitation, nutrition, respiratory and pastoral care workers. Symptom distress (multiple visual analogue scales), cognition, and CAGE (alcoholism) were determined. Recommendations were given to the patient and sent to the oncologist, family physician and home care nurse. For 110 patients a second assessment was carried out 1 week later, and 64 patients underwent a telephone assessment 2 weeks after the second visit. Symptom intensity was determined during initial and follow-up visits, as well as during two follow-up telephone assessments. In addition, demographics and patient satisfaction with the SCC were determined. Overall symptom distress, depression, anxiety and sensation of wellbeing improved significantly from the first (n = 166) to the second clinic visit (n = 110). Further significant improvement was observed in overall symptom distress, pain, anxiety, sense of wellbeing and depression at the 2- (n = 64) and 4-week (n = 38) telephone follow-up assessments. Mean satisfaction with the SCC (0-10) was 7.7 +/- 2. Our findings suggest that the work of the SCC results in long-term effectiveness in symptom control and high levels of patient satisfaction. The SCC allows for better integration of care between a cancer center and community-based physicians and nurses. It also allows patients access to multiple disciplines that are not available outside tertiary centers.
Bruera
E
E
Department of Symptom Control and Palliative Care, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. ebruera@mail.manderson.org
Michaud
M
M
Vigano
A
A
Neumann
C M
CM
Watanabe
S
S
Hanson
J
J
D000328:Adult; D000368:Aged; D002173:Cancer Care Facilities / Q000458:organization & administration* / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D018710:Pain Clinics / Q000458:organization & administration* / Q000592:standards; D010348:Patient Care Team; D010358:Patient Participation; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D012189:Retrospective Studies; D013781:Texas