Document Detail


Symptom and medication profiles among cancer patients attending a palliative care clinic.
MedLine Citation:
PMID:  17429699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with advanced cancer frequently experience distressful symptoms and receive numerous medications. We describe the symptomatology and medication profile of ambulatory cancer patients receiving exclusively supportive care at the Princess Margaret Hospital. MATERIALS AND METHODS: This was a retrospective, cross-sectional study. We reviewed the charts of consecutive adult cancer patients attending palliative care clinics and who were no longer receiving cancer-directed therapy. From the medical records, we collected information about self-reported symptoms [screened for with the numerical Edmonton symptom assessment system (ESAS) scale; range, 0-10, with 10=worst symptom] and medication profiles. Summary statistics were used to describe the results. RESULTS: Two hundred fifty five patients met the inclusion criteria. The most frequent self-reported symptoms of any severity were fatigue (77%), pain (75%), and lack of appetite (66%). These were also the most severe symptoms: fatigue (median ESAS score=7), pain (median ESAS=5), and lack of appetite (median ESAS=5). The median number of medications per patient after consultation in the palliative care service was 6, and the most common classes of drugs prescribed were opioids (67%), laxatives/stool softeners (54%), corticosteroids (41%), and acetaminophen (41%). Palliative care physicians made at least one medication change in 75% of the patients, with the most frequent change being the addition of new medication(s); dexamethasone was the most commonly added individual drug (18% of the patients). CONCLUSION: Among patients with advanced cancer not receiving antineoplastic therapy, the most frequent and severe symptoms were fatigue, pain, and lack of appetite. The medication profile represented drugs that could both alleviate and contribute to these symptoms. Audit of patient symptoms and medication prescription in palliative care may inform clinical practice and help the development of research specific to patient symptoms.
Authors:
Rachel P Riechelmann; Monika K Krzyzanowska; Aoife O'Carroll; Camilla Zimmermann
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Publication Detail:
Type:  Journal Article     Date:  2007-04-12
Journal Detail:
Title:  Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer     Volume:  15     ISSN:  0941-4355     ISO Abbreviation:  Support Care Cancer     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-08     Completed Date:  2008-02-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9302957     Medline TA:  Support Care Cancer     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1407-12     Citation Subset:  IM    
Affiliation:
Department of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ambulatory Care Facilities*
Analgesics / therapeutic use
Analgesics, Opioid / therapeutic use
Antineoplastic Agents / therapeutic use*
Cross-Sectional Studies
Disease Progression
Female
Health Status Indicators
Humans
Male
Middle Aged
Neoplasms / drug therapy,  physiopathology,  therapy*
Palliative Care*
Retrospective Studies
Sickness Impact Profile
Chemical
Reg. No./Substance:
0/Analgesics; 0/Analgesics, Opioid; 0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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