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Predictors of outpatients’ request for palliative care service at a medical oncology clinic of a German comprehensive cancer center

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Abstract

Purpose

Early integration of palliative care (PC) is recommended. The determination of predictors for patients’ request for PC may guide implementation in clinical practice. Toward this end, we analyzed the symptom burden and distress of cancer patients in outpatient care and examined their need and request for PC.

Methods

Between October 2013 and March 2016, 705 patients receiving outpatient cancer treatment took part in the survey. We used the new MInimal DOcumentation System to detect symptom clusters. Additionally, patients’ request for palliative and psychosocial support was assessed. Groups of patients with PC request were compared to patients without PC request regarding their symptom clusters. Logistic regression analysis was applied to discover significant predictors for the requested inclusion of PC.

Results

A total of 159 patients (25.5%) requested additional support by PC. Moderate and severe tiredness (40.3%), weakness (37.9%), pain (25.0%), loss of appetite (22.3%), and dyspnea (19.1%) were the most frequent symptoms. The group of patients requesting PC differed significantly in terms of pain, nausea, dyspnea, constipation, weakness, loss of appetite, tiredness, depression, and anxiety from patients without request for PC (p < .01). The perceived need for PC was identified by the significant predictors “depression,” “anxiety,” and “weakness” with an explained variance of 22%.

Conclusion

Combining a standardized screening questionnaire and the assessment of patients’ request for PC allows systematic monitoring for patients’ need for PC in a large Medical Oncology clinic. Depression, anxiety, and weakness are predictors of requesting PC service by patients receiving outpatient cancer treatment.

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Authors and Affiliations

  1. West German Cancer Center, Department of Medical Oncology, University Hospital Essen, 45122, Essen, Germany

    Mitra Tewes, Teresa Rettler, Nathalie Wolf, Jörg Hense & Martin Schuler

  2. German Cancer Consortium (DKTK), Partner Site University Hospital Essen, 45122, Essen, Germany

    Martin Schuler

  3. Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg Essen, LVR-Klinikum Essen, 45122, Essen, Germany

    Martin Teufel & Mingo Beckmann

Authors
  1. Mitra Tewes
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  2. Teresa Rettler
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  3. Nathalie Wolf
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  4. Jörg Hense
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  5. Martin Schuler
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  6. Martin Teufel
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  7. Mingo Beckmann
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Corresponding author

Correspondence to Mitra Tewes.

Ethics declarations

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. The local ethical review committee of the University of Essen approved the data analysis (16-6800-BO). Informed consent was obtained from all patients for being included in the study. This article does not contain any studies with human or animal subjects.

Conflict of interest

The authors declare that they have no conflict of interest.

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Tewes, M., Rettler, T., Wolf, N. et al. Predictors of outpatients’ request for palliative care service at a medical oncology clinic of a German comprehensive cancer center. Support Care Cancer 26, 3641–3647 (2018). https://doi.org/10.1007/s00520-018-4245-7

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  • DOI: https://doi.org/10.1007/s00520-018-4245-7

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