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Published on: August 1, 2019
Timing and outcomes of outpatient palliative care consultations in advanced cancer
Juan Luis Torres-Tenor1, Eduardo Bruera2, María José Ortí-Hortelano3
1Department of Palliative Care, La Paz Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain. torrestenor@yahoo.es.
Purpose:
To assess the timeliness of referral to an outpatient palliative care clinic for patients with advanced cancer and to evaluate key markers of intervention efficacy.
Methods/Patients:
Retrospective study of 177 consecutive patients with advanced cancer referred to outpatient palliative care in a tertiary hospital.
Results:
Median survival post-referral was 268 days (95% CI 228-308). Fatigue (48%) and pain (21%) were the most frequent symptoms. Significant symptom improvement was observed between initial and second visits: the median ESAS score dropped from 7 (5-8) to 5 (3-7) (p < 0.001). Severe ESAS scores for the primary symptom decreased from 63 to 30% (p < 0.001). Advance Care Planning (ACP) was documented in 94% of patients. 1% of deceased patients received anticancer treatment in the last 14 days, 7% in the last 30 days.
Conclusions:
Early palliative care referral was associated with improved symptoms, higher rates of ACP, and reduced aggressive end-of-life care, supporting the expansion of palliative care resources.
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