title: Projected referral to other healthcare services in an outpatient palliative radiotherapy clinic.
abstract: OBJECTIVE
  To investigate the projected referral to other healthcare services in an outpatient palliative radiotherapy clinic.
  
  
  METHODS
  Patients referred for palliative radiotherapy from 1999 to 2002 inclusive and 2007 to 2009 inclusive were evaluated. The Edmonton Symptom Assessment System, which assesses nine symptoms, was completed by 1439 patients prior to radiotherapy consultation. The numeric scale was converted into a categorical scale of none, mild, moderate and severe. Patients with moderate-to-severe symptoms were identified as potential referrals to other healthcare services.
  
  
  RESULTS
  Tiredness (66%), poor sense of wellbeing (64%), pain (57%) and poor appetite (52%) had the most patients scoring in the moderate-to-severe range. Moderate-to-severe anxiety and depression occurred in 39 and 30% of patients, respectively, reflecting the percentage of projected referrals for symptom and/or psychosocial management.
  
  
  CONCLUSIONS
  Cancer symptoms are complex, and a multidisciplinary and collaborative approach should be taken to provide timely management and maintain patients' quality of life.
authors.affiliation: Rapid Response Radiotherapy Program, Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, University of Toronto, Toronto, ON, M4N 3M5, Canada.
authors.forename: Janet
authors.initials: J
authors.lastname: Nguyen
authors.forename: Julia
authors.initials: J
authors.lastname: Di Giovanni
authors.forename: Liying
authors.initials: L
authors.lastname: Zhang
authors.forename: Marko
authors.initials: M
authors.lastname: Popovic
authors.forename: Liang
authors.initials: L
authors.lastname: Zeng
authors.forename: Rehana
authors.initials: R
authors.lastname: Jamani
authors.forename: Gemma
authors.initials: G
authors.lastname: Cramarossa
authors.forename: Shaelyn
authors.initials: S
authors.lastname: Culleton
authors.forename: Florence
authors.initials: F
authors.lastname: Jon
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000532:radiotherapy; D009369:Neoplasms / Q000150:complications / Q000532:radiotherapy / Q000628:therapy*; D010044:Outpatient Clinics, Hospital; D010166:Palliative Care / Q000706:statistics & numerical data*; D010348:Patient Care Team; D011878:Radiotherapy / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012737:Sex Factors; D055815:Young Adult