Patient appointment process, symptom control and prediction of follow-up compliance in a palliative care outpatient clinic.

Abstract

Activities and outcomes in an outpatient palliative care clinic (PCC) have attracted little attention in the literature. We describe the results of our patient appointment scheduling process, our efficacy in relieving cancer-associated symptoms and an analysis of risk factors for patient non-compliance with the appointment schedule. Over a one-year study period, 730 first-time appointments were scheduled and 73.1% of them were kept. Only patients who had kept 3 consecutive visits (n=203) were included in the symptom control analysis. All symptoms except constipation, physical weakness, and anxiety improved significantly with palliative care. History of alcohol abuse was not associated with poorer pain control. A low Karnofsky index and high anxiety levels were identified as risk factors for early withdrawal from the PCC scheduled appointment. These data indicate that the PCC is an effective place for symptom management, but specific organizational strategies are needed to encourage patients to comply with scheduled appointments.