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Innovative Model for Symptom Management

J Palliat Med; ePub 2017 May 24; Foxwell, et al

Office hours are an efficient way to address palliative care needs of patients with hematologic malignancies when demand exceeds capacity, according to a recent retrospective study.

Under the model, a palliative care nurse practitioner or pharmacist was available to inpatient hematologic oncology providers at an academic medical center. They offered advice on pain, non-pain symptoms, and psychosocial distress. Investigators evaluated outcomes 6 months after the process was initiated. Among the results:

  • Palliative care office hours lasted an average of 16 minutes/day.
  • An average of 11 patients were discussed/week.
  • Pain, nausea, and anxiety were the addressed most frequently.
  • 15% of ~300 patients discussed during office hours eventually required a full palliative care consult.
  • Overall, palliative care consults decreased from 20% to 10% of admissions, whereas consults involving goals for care increased.

The authors noted that the process enables primary care teams to manage basic palliative care issues independently over time.


Foxwell A, Moyer M, Casarett D, O'Connor N. Palliative care office hours for patients with hematologic malignancies: An innovative model for symptom management and education. [Published online ahead of print May 24, 2017]. J Palliat Med. doi:10.1089/jpm.2017.0091.