1343P - Current trend of Palliative Care Clinic (PCC) referrals and their impact on symptom burden in patients (Pts) who are seen in Genitourinary Medical...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Palliative Care
Genitourinary Cancers
Presenter neha Gupta
Citation Annals of Oncology (2014) 25 (suppl_4): iv471-iv477. 10.1093/annonc/mdu350
Authors N. Gupta1, S. Gandhi2, S. Anwar2, R. Pili3, Y. Satchidanand4
  • 1Palliative Medicine, State University of New York at Buffalo, 14263 - Buffalo/US
  • 2Internal Medicine, State University of New York at Buffalo, 14263 - Buffalo/US
  • 3Medical Oncology, Roswell Park Cancer Institute, 14263 - Buffalo/US
  • 4Palliative Medicine, Roswell Park Cancer Institute, 14263 - Buffalo/US

Abstract

Aim

1) To assess the frequency of specialist PCC referrals in our GUMOC. 2) To analyze the impact of PCC referrals on the symptomatology of patients.

Methods

239 consecutive pts were collected from a retrospective review of GUMOC records in Roswell Park Cancer Institute from 12/1/2013 to 2/28/2014. This group of pts was used to assess the frequency of PCC referral. Pts were divided into two arms- Arm A= GUMOC pts referred to PCC; Arm B: GUMOC pts not referred to PCC. To be able to detect a 15% between the two arms at 95% significance, 37 additional pts (who were already being seen at GUMOC) were collected from retrospective review of PCC records over 9/1/2013 to 2/28/2014. Total 276 patients were divided into Arm A (n = 49), Arm B (n = 227 patients). Arm B includes 12 pts from GUMOC records and 37 pts from PCC records. Data for baseline symptom score and 4-week follow up symptom scores were collected. A palliative care screening tool (retrieved from Center to Advance Palliative care [CAPC] website) was used to assign a palliative care screening score (PCSS) to all study patients. Chi square test and T-test used respectively for categorical variables and numerical variables.

Results

Out of the 239 initially collected GUMOC patients, 5% were referred to PCC. 10% (n = 24) had PCSS score of ≥ 4, and 33% pts with PCSS ≥ 4 were referred to PCC. Baseline symptoms, ECOG status (2-3) and cancer stage (locally advanced or stage 4) were more advanced in the Arm A vs. Arm B (p = 0.02, p < 0.01, p < 0.01 respectively). On comparing the symptom score change from baseline to 4-week follow-up, significant improvement occurred in Arm A (vs. Arm B) in pain (p = <0.01), nausea (p = <0.01), depression (p < 0.01), anxiety (p < 0.01), drowsiness (<0.01), anorexia (p < 0.01), well-being (<0.01), dyspnea (p = 0.02), and mean score (p < 0.01).

Conclusions

GU cancer patients who are referred to PCC from medical oncology clinic have significant decrease in distressing symptoms. Frequency of PCC consultation is still low in comprehensive cancer institutes, and not in congruence with the available palliative care screening tools criteria suggested by CAPC. Standardized tools should be developed to guide PCC referrals, and routine use of these tools may help selecting patients who will benefit the most from PCC referral.

Disclosure

All authors have declared no conflicts of interest.