Palliative care in the outpatient oncology setting: Evaluation of a practical set of referral criteria Journal Article


Authors: Glare, P. A.; Semple, D.; Stabler, S. M.; Saltz, L. B.
Article Title: Palliative care in the outpatient oncology setting: Evaluation of a practical set of referral criteria
Abstract: Background: The National Comprehensive Cancer Network's (NCCN) palliative care (PC) guidelines recommend screening all patients for PC issues at the first visit with their oncologist and at subsequent, clinically relevant times. Criteria for referral to a PC specialist are also part of the guideline. We evaluated the feasibility of screening for PC needs in outpatients attending one GI oncology practice specializing in colorectal cancer and neuroendocrine tumors. Methods: All patients attending clinic during a 3-week period were screened by the office practice nurse (OPN). A one-page screening tool based on the NCCN guidelines was developed, giving a score from 0 to 13. The OPN also evaluated the NCCN referral criteria. Results: There were 152 clinic visits by 125 patients during the surveillance period; 119 were screened. Median age was 61 years; half were male. Eighty percent had colorectal cancer, and two thirds had advanced disease. Screening took approximately 3 to 5 minutes per patient. Depending on the PC definition used, between 7% and 17% of patients screened positive; all met the NCCN referral criteria. Psychosocial distress was commoner than physical symptoms. The maximum screening score was 8. A cut point of 5 had the best predictive value for specialist referral, and would result in 13% patients having PC consultations. Conclusion: Screening identified 7% to 17% of patients in this busy clinic as having PC issues and 13% who might benefit from specialist referral. But even this simple method adds considerably to the clinic workload, so the benefits of implementing routine screening need to be carefully evaluated. Copyright © 2011 by American Society of Clinical Oncology.
Journal Title: Journal of Oncology Practice
Volume: 7
Issue: 6
ISSN: 1554-7477
Publisher: American Society of Clinical Oncology  
Date Published: 2011-11-01
Start Page: 366
End Page: 370
Language: English
DOI: 10.1200/jop.2011.000367
PROVIDER: scopus
PMCID: PMC3219462
PUBMED: 22379418
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 1 May 2012" - "Source: Scopus"
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MSK Authors
  1. Leonard B Saltz
    791 Saltz
  2. Paul A Glare
    61 Glare
  3. Stacy Marie Stabler
    13 Stabler
  4. Deborah S Semple
    7 Semple