title: Patient appointment process, symptom control and prediction of follow-up compliance in a palliative care outpatient clinic.
abstract: Activities and outcomes in an outpatient palliative care clinic (PCC) have attracted little attention in the literature. We describe the results of our patient appointment scheduling process, our efficacy in relieving cancer-associated symptoms and an analysis of risk factors for patient non-compliance with the appointment schedule. Over a one-year study period, 730 first-time appointments were scheduled and 73.1% of them were kept. Only patients who had kept 3 consecutive visits (n=203) were included in the symptom control analysis. All symptoms except constipation, physical weakness, and anxiety improved significantly with palliative care. History of alcohol abuse was not associated with poorer pain control. A low Karnofsky index and high anxiety levels were identified as risk factors for early withdrawal from the PCC scheduled appointment. These data indicate that the PCC is an effective place for symptom management, but specific organizational strategies are needed to encourage patients to comply with scheduled appointments.
authors.affiliation: Palliative Care Service, Institut Català d'Oncologia, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
authors.forename: Núria
authors.initials: N
authors.lastname: Codorniu
authors.forename: Xavier
authors.initials: X
authors.lastname: Gómez-Batiste
authors.forename: Eulalia
authors.initials: E
authors.lastname: Alburquerque
authors.forename: Gala
authors.initials: G
authors.lastname: Serrano-Bermúdez
authors.forename: Daniel
authors.initials: D
authors.lastname: Sánchez-Posadas
authors.forename: Xavier
authors.initials: X
authors.lastname: Pérez-Martin
authors.forename: Jesús
authors.initials: J
authors.lastname: González-Barboteo
authors.forename: Albert
authors.initials: A
authors.lastname: Tuca-Rodríguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001071:Appointments and Schedules; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care; D010349:Patient Compliance; D012017:Referral and Consultation; D016896:Treatment Outcome