1615PEmbedded outpatient palliative care service within the oncology clinic: Preliminary experience in Hacettepe Oncology Hospital

Abstract Background Outpatient palliative care (OPC) offers improved symptom control, quality of life and even survival. OPC clinics may be embedded in the oncology clinic or independent. We herein present our experience with an embedded OPC clinic led by a medical oncologist, an internist and a nurse in Hacettepe University Medical Oncology Clinic. Methods Patients who were referred by their oncologist or those who had severe symptoms and applied without referral were admitted. Besides baseline history and physical exam, Edmonton Symptom Assesment Scale (ESAS), Nutritional risk screening 2002 and visual analog scale for pain were routinely assessed except for patients with acute symptoms requiring urgent intervention. Interventions and consultations were recorded for all patients. Results A total of 174 patients were seen in our clinic within the first 5 months. Demographic features are shown in the table. The chief complaints were pain (26%), nausea and vomiting (13%) and decreased feeding (9%). Besides their chief complaints, patients had a median of 4 (min 0- max 8) other severe (ESAS score of > 5) complaints. The most frequent interventions were intravenous hydration, analgesic and/or antiemetic administration and prescription (n = 66), nutritionist (n = 62) and pain specialist (n = 59) consultations. Thirty-three patients (19 %) were referred for immediate hospitalization. The overall mortality within the first 30 days after the first OPC visit was 17%. Table . 1615P Baseline characteristics of the applied patients Median Age (minimum- maximum) 60.5 (17-91) Male/Female 94 (58%)/80 (42%) Patient Stages Stage 1: 4 (2.3%) Stage 2: 7 (4%) Stage 3: 18 (10.3%) Stage 4: 157 (73.6%) ECOG Performance Status ECOG 0: 19 (10.9%) ECOG 1: 50 (28.7%) ECOG 2: 36 (20.7%) ECOG 3: 40 (23%) ECOG 4: 25 (14.4%) Tumor Sites Gastrointestinal: 53 (30.5%) Lung: 43 (24.7%) Genitourinary: 15 (8.6%) Breast: 14 (8%) Gynecologic: 11 (6.3%) Head and Neck Cancer: 9 (5.2%) Other: 29 (16.7%) Conclusions Our initial experience with the embedded OPC clinic mostly included patients with advanced disease, multiple severe symptoms and high risk of mortality. Management of these patients within the oncology clinic may address palliative care needs of these patients, provide timely therapeutic interventions, reduce unnecessary diagnostic tests and diminish emergency department applications by these patients. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.