Supportive Care in Cancer

, Volume 15, Issue 12, pp 1407–1412

Symptom and medication profiles among cancer patients attending a palliative care clinic

  • Rachel P. Riechelmann
  • Monika K. Krzyzanowska
  • Aoife O’Carroll
  • Camilla Zimmermann
Original Article

DOI: 10.1007/s00520-007-0253-8

Cite this article as:
Riechelmann, R.P., Krzyzanowska, M.K., O’Carroll, A. et al. Support Care Cancer (2007) 15: 1407. doi:10.1007/s00520-007-0253-8

Abstract

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.

Keywords

Palliative care clinic Antineoplastic therapy Ambulatory cancer Symptom assessment 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Rachel P. Riechelmann
    • 1
  • Monika K. Krzyzanowska
    • 1
  • Aoife O’Carroll
    • 1
  • Camilla Zimmermann
    • 2
  1. 1.Department of Medical Oncology and Hematology, Princess Margaret HospitalUniversity of TorontoTorontoCanada
  2. 2.Department of Psychosocial Oncology and Palliative Care, Princess Margaret HospitalUniversity of TorontoTorontoCanada

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