title: Beyond palliative radiotherapy: a pilot multidisciplinary brain metastases clinic.
abstract: OBJECTIVE
  The purpose of this study is to determine the feasibility of a multidisciplinary palliative radiotherapy clinic for patients with brain metastases.
  
  
  METHODS
  We designed a 6-month pilot Rapid Access Palliative Radiotherapy Program (RAPRP) brain metastases clinic. The main goals of the clinic were: (1) to provide timely consultation and treatment, (2) to provide multidisciplinary assessment and care, (3) to facilitate accrual of patients to research studies, and (4) to be a positive experience for patients. Team members included a radiation oncologist, radiation therapist, nurse practitioner, social worker (SW), occupational therapist (OT), and registered dietitian (RD). Patients underwent multidimensional assessment with patient-reported questionnaires and completed a patient satisfaction survey. Data were collected in a prospective database and collated in a standardized fashion with descriptive statistics recorded as percentages, medians, and ranges.
  
  
  RESULTS
  The pilot brain metastases clinic ran weekly from August 5, 2009 to January 27, 2010. In total, 33 patients were seen. The median time from referral date to clinic date was 6 days, with 76% of patients seen within 1 week. Most patients (94%) started their radiotherapy on clinic day. Fifteen patients (45%) required assessment by a SW, 36% by an OT, and 33% by a RD. Ninety-one percent of patients participated in a research study. Eighty-six percent of patients reported being very satisfied with the clinic experience, and 97% would recommend the clinic to a patient in a similar situation.
  
  
  CONCLUSIONS
  The pilot RAPRP Brain Metastases Clinic was successful in providing patients with timely and multidisciplinary care and will continue beyond the pilot phase.
authors.affiliation: Department of Oncology, University of Alberta Division on Radiation Oncology, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, Canada T6G 1Z2. brita.danielson@albertahealthservices.ca
authors.forename: Brita
authors.initials: B
authors.lastname: Danielson
authors.forename: Alysa
authors.initials: A
authors.lastname: Fairchild
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D016208:Databases, Factual; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D012106:Research / Q000458:organization & administration / Q000706:statistics & numerical data*; D013997:Time Factors