title: Effectiveness of a specialized outpatient palliative care service as experienced by patients and caregivers.
abstract: OBJECTIVE
  In Germany since 2007 patients with advanced life-limiting diseases are eligible for Specialized Outpatient Palliative Care (SOPC). To provide this service, SOPC teams have been established as a new facility in the health care system. The objective of this study was to evaluate the effectiveness of one of the first SOPC teams based at the Munich University Hospital.
  
  
  METHODS
  All patients treated by the SOPC team and their primary caregivers were eligible for this prospective nonrandomized study. The main topics of the surveys before and after involvement of the SOPC team were: for patients, the assessment of symptom burden (Minimal Documentation System for Palliative Medicine, MIDOS), satisfaction with quality of palliative care (Palliative Outcome Scale, POS), and quality of life (McGill Quality of Life Questionnaire, MQOL); for caregivers, burden of care (Häusliche Pflegeskala, home care scale, HPS), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), and quality of life (Quality of Life in Life-Threatening Illness-Family Carer Version, QOLLTI-F).
  
  
  RESULTS
  Of 100 patients treated between April and November 2011, 60 were included in the study (median age 67.5 years, 55% male, 87% oncological diseases). In 23 of 60 patients, only caregivers could be interviewed. The median interval between the first and second interview was 2.5 weeks. Quality of life increased significantly in patients (p<0.05) and caregivers (p<0.001), as did the patients' perception of quality of palliative care (POS, p<0.001), while the caregivers' psychological distress and burden of care significantly decreased (HADS, p<0.001; HPS, p<0.001).
  
  
  CONCLUSIONS
  The involvement of an SOPC team leads to a significant improvement in the quality of life of patients and caregivers and can lower the burden of home care for the caregivers of severely ill patients.
authors.affiliation: Pediatric Palliative Care Service, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-University, Munich, Germany. Gesa.Groh@med.uni-muenchen.de
authors.forename: Gesa
authors.initials: G
authors.lastname: Groh
authors.forename: Birgit
authors.initials: B
authors.lastname: Vyhnalek
authors.forename: Berend
authors.initials: B
authors.lastname: Feddersen
authors.forename: Monika
authors.initials: M
authors.lastname: Führer
authors.forename: Gian Domenico
authors.initials: GD
authors.lastname: Borasio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000523:psychology* / Q000639:trends; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D005260:Female; D005858:Germany; D006699:Home Care Services / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000523:psychology* / Q000639:trends; D010348:Patient Care Team / Q000458:organization & administration / Q000639:trends; D017060:Patient Satisfaction; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards / Q000639:trends; D011788:Quality of Life; D011795:Surveys and Questionnaires; D019452:Terminally Ill / Q000523:psychology*; D000078329:Workforce