Impact of outpatient palliative care (PC) on symptom burden in patients with advanced cancer at a tertiary cancer center in Jordan

Purpose Outpatient palliative care clinics are essential for early symptom management in patients with advanced cancer. Few outpatient programs are available in the Middle East. In this prospective study, we examined the symptom changes among cancer patients seen at a palliative care clinic in Jordan. Methods Patients with advanced cancer who had an outpatient palliative care consultation and not delirious were enrolled. The Edmonton Symptom Assessment System (ESAS), Karnofsky Performance Scale (KPS), and Memorial Delirium Assessment Scale (MDAS) were collected at consultation and follow up visit 14–34 days later. We compared symptom changes using paired t test. Results Among the 182 enrolled patients, the average age was 53 years, 47 % were females, and 95 % had stage IV cancer. The median duration between the two clinic visits was 21 days (interquartile range 15–28). KPS decreased between visits (mean 68 vs. 66 %, P = 0.004). ESAS pain (5.9 vs. 5.1, P = 0.004) and sleep (4.6 vs. 4.1, P = 0.007) improved significantly over time. The remaining ESAS symptoms decreased in intensity, albeit not statistically significant. Among patients who presented with moderate to severe symptom intensity, pain (7 vs. 6, P