title: 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: a retrospective descriptive study.
abstract: 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.
authors.affiliation: Section Oncology and Palliative Medicine, Department of Internal Medicine, Kantonsspital, St.Gallen, Switzerland.
authors.forename: Florian
authors.initials: F
authors.lastname: Strasser
authors.forename: Catherine
authors.initials: C
authors.lastname: Sweeney
authors.forename: Jie
authors.initials: J
authors.lastname: Willey
authors.forename: Susanne
authors.initials: S
authors.lastname: Benisch-Tolley
authors.forename: J Lynn
authors.initials: JL
authors.lastname: Palmer
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D018710:Pain Clinics / Q000706:statistics & numerical data*; D059408:Pain Management; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome