Phase II Study of an Outpatient Palliative Care Intervention in Patients With Metastatic Cancer

Follwell, Matthew; Burman, Debika; Le, Lisa W.; Wakimoto, Kristina; Seccareccia, Dori; Bryson, John; Rodin, Gary; Zimmermann, Camilla

doi:10.1200/jco.2008.17.7568

Cited by 207 publications

(153 citation statements)

References 49 publications

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“…The interval of 6 days between referral and death in this sample of patients with acute leukemia is similar to that reported in retrospective studies of patients with hematological malignancies, which have reported intervals between referral and death of 2 weeks or less [18,19]. There is increasing evidence of the benefit of early palliative care in patients with metastatic cancer [11][12][13][14][15]. Models of palliative and supportive care, designed specifically for patients with acute leukemia, may be useful to support patients through the symptoms and distress associated with intensive treatment, and potentially to the end of life.…”

Section: Discussionsupporting

confidence: 61%

“…There has been recent acknowledgment of the relevance of palliative care for patients with hematological malignancies [10], and accumulating evidence of the benefit of palliative care when provided concurrently with curative or life-prolonging treatment [11][12][13][14][15]. However, there have been no prospective studies assessing referral to palliative care and psychosocial services for patients with acute leukemia and correlating these data with symptom severity.…”

Section: Introductionmentioning

confidence: 99%

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Symptom burden and supportive care in patients with acute leukemia

Zimmermann¹,

Yuen²,

Mischitelle³

et al. 2013

Leukemia Research

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126

116

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We examined the symptoms and referral rates to specialized palliative care and psychosocial oncology services of patients with acute leukemia. The Memorial Symptom Assessment Scale (MSAS) was completed by 249 adult patients with acute leukemia. Patients reported a median of 9 physical and 2 psychological symptoms, and those with intense lack of energy, difficulty sleeping and pain were more likely to report intense worrying/sadness (P < 0.001). No patients with moderate-severe pain were referred for specialized symptom control and only 13% of those with severe worrying/sadness were referred to psychiatry/psychology within one month of the *

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Symptom burden and supportive care in patients with acute leukemia

Zimmermann¹,

Yuen²,

Mischitelle³

et al. 2013

Leukemia Research

Self Cite

126

116

View full text Add to dashboard Cite

show abstract

“…Traditionally, palliative care has been delivered late in the disease course, 1 as physicians tend to perceive palliative care (PC) as the alternative to life-prolonging or curative care. Studies suggest that late referrals to palliative care are inadequate to alter the quality and delivery of care provided to patients with cancer.…”

Section: What Is Already Known?mentioning

confidence: 99%

Update in Palliative Care - 2011

et al. 2011

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“…Different versions of the ESAS have been used in research studies [9][10][11][12]. Recent studies have indicated that patients may have difficulty understanding the terminology and correct use of the ESAS [9,[13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Health care providers’ use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

Buttenschoen

Stephan²,

Watanabe

et al. 2013

Support Care Cancer

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Objectives The ESAS is a clinical symptom assessment tool developed for patients receiving palliative care for pain and symptom control. Recent studies have indicated that patients have difficulty understanding terminology and correct use of the ESAS, and that they appreciate the presence of a health care provider (HCP) to assist with ESAS completion. As appropriate assessment translates into effective treatment, it is important that HCPs have a good understanding of the tool. The purpose of this study was to assess HCPs' use, knowledge, and training needs of the ESAS. Methods One hundred ninety-three HCPs in palliative care and chronic pain, who used the ESAS, were invited to participate in a survey. Results The response rate was 43 % (n =83), with 62 % nurses, 26 % physicians, and 12 % other specialties. Most participants were palliative care specialists (79 %). The majority (77 %) had a good understanding of the ESAS terms. Knowledge problems included distinguishing tiredness and drowsiness (25 %), interpreting shortness of breath as a combination of subjective and objective symptoms (19 %), not indicating current symptom level (14 %), and reverse scoring of well-being (13 %) and appetite (9 %). Reported challenges were misinterpretation of some ESAS terms, assessing patients with impaired communication, and lack of time and reliability of caregiver assessments. Participants offered suggestions regarding how their knowledge and use of the ESAS could be improved. Conclusions Suggestions for improving ESAS administration and training were to include term definitions and examples of how to ask about terms that might be challenging for patients. Furthermore, initial and ongoing training sessions might help to clarify issues with the tool.

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Phase II Study of an Outpatient Palliative Care Intervention in Patients With Metastatic Cancer

Abstract: This phase II study demonstrates efficacy of an OPCC for improvement of symptom control and patient satisfaction with care. Randomized controlled trials are indicated to further evaluate the effectiveness of specialized outpatient palliative care.

Cited by 207 publications

References 49 publications

Symptom burden and supportive care in patients with acute leukemia

Symptom burden and supportive care in patients with acute leukemia

Update in Palliative Care - 2011

Health care providers’ use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

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