Impact of a half-day multidisciplinary symptom control and palliative care outpatient clinic in a comprehensive cancer center on recommendations, symptom intensity, and patient satisfaction: a retrospective descriptive study

J Pain Symptom Manage. 2004 Jun;27(6):481-91. doi: 10.1016/j.jpainsymman.2003.10.011.

Abstract

To characterize a new, one-stop multidisciplinary palliative care (MD) clinic which offers standardized multidisciplinary assessment, specific care recommendations, patient and family education, and on-site counseling, we retrospectively compared the assessments of 138 consecutive patients with advanced cancer referred to the MD clinic and 77 patients referred to a traditional pain and symptom management (PSM) clinic. The two groups were similar in tumor type, demographics, and symptom distress. The MD clinic team (physicians; nurses; pharmacists; physical, speech, and occupational therapists; social workers; chaplains; nutritionists; psychiatric nurse practitioner) delivered 1,066 non-physician recommendations (median 4 per patient, range 0-37). The PSM clinic team made no non-physician recommendations, but referred 14 patients to other medical specialists. In 80 (58%) MD-clinic patients with follow-up 9 days (median) after assessment, significant improvement was observed in pain, nausea, depression, anxiety, sleep, dyspnea, and well-being, but not in fatigue, anorexia, or drowsiness. In 83 patients interviewed after the MD clinic, satisfaction was rated as excellent (5 out of 5) in 86-97% of seven areas. Assessment at an MD clinic results in a high number of patient care recommendations, improved symptoms, and high levels of patient satisfaction.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / epidemiology*
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Outpatient Clinics, Hospital / statistics & numerical data
  • Pain / epidemiology*
  • Pain / psychology
  • Pain Clinics / statistics & numerical data*
  • Pain Management*
  • Pain Measurement
  • Palliative Care / methods*
  • Palliative Care / psychology
  • Palliative Care / statistics & numerical data*
  • Patient Satisfaction / statistics & numerical data
  • Quality Assurance, Health Care / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Treatment Outcome