title: Effects of a symptom control intervention on utilization of health care services among cancer patients.
abstract: BACKGROUND
  In this study we investigated the effects of a clinical nursing symptom control intervention on utilization of physician, hospital and emergency room services.
  
  
  METHODS
  Two hundred twenty-two patients currently undergoing chemotherapy were recruited for the study, and were randomized into either the 10-contact, 20-week experimental intervention group (110), where the intervention focused on assisting the patient in managing their symptoms, or to a conventional care control group (112).
  
  
  RESULTS
  A random effects regression model revealed that patients in the intervention group reported fewer emergency room visits than patients in the control group (p=0.050). Greater symptom severity and more comorbid conditions were also predictive of more emergency room visits. The intervention was effective in reducing the number of hospital visits for the subgroup of patients who at baseline reported above average symptom severity (p=0.023).
  
  
  CONCLUSIONS
  These findings suggest that a nursing intervention focusing on educating patients regarding specific strategies to be applied for controlling symptoms may be worthwhile, as the patients may regain some control in managing their symptoms and thus ultimately require fewer emergency room services and hospital visits. Such a straightforward approach may empower patients, enhance their quality of life and reduce overall costs of cancer care.
authors.affiliation: Department of Family and Community Medicine, Michigan State University, East Lansing, MI 48824, USA. kurtzm@msu.edu
authors.forename: Margot E
authors.initials: ME
authors.lastname: Kurtz
authors.forename: J C
authors.initials: JC
authors.lastname: Kurtz
authors.forename: Charles W
authors.initials: CW
authors.lastname: Given
authors.forename: Barbara
authors.initials: B
authors.lastname: Given
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D009369:Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D010353:Patient Education as Topic; D012720:Severity of Illness Index
chemical_list: D000970:Antineoplastic Agents