Introduction: There are few literature about sistematic assessment system in the consults of the palliative care service, that lets to establish a policy of quality. For this reason, it?s interesting to study this system in our environment.
Objective: To establish a clinical management system in consults that lets: 1) an individual and multidimensional assessment; 2) a definition of type of patients in our consults; 3) evaluation of the clinical results that helps to do guidelines and protocols.
Method: Sistematic assessment of the clinical data in the first visit in the consult (CAGE, Edmonton Staging System, social and psycological risk indicators, KPS, Barthell and MMSE) and sistematic assessment by a numeric scale (NS) (0 10) of pain, anorexia, constipation, insomnia, fatigue, anxiety, depression in the first visit and the 2 following visits. It didn't evaluate the patients who didn?t complete the 3 visits. Consecutive patients from Oct-01 to Dec-02 were analyzed. Data were recorded in an electronic data base (ACCESS) and were analyzed by SPSS 9.0 windows.
Results: 543 patients participated: 71.3% men. Mean age 64.7 years. KPS 70 (average). Psycopathology history 18.2%, CAGE | 26.6%. Cognitive impairment in the first visit 19.3%. 14.8% patients hadn't pain, ESSI 39%, ESSII 46.3%. Third step analgesic (morphine 16.7%, methadone 1.3%, fentanil TTS 10.9%).201 patients were analyzed. 70% of the 333 remaining patients were admitted in the Palliative Care Unit before the third visit in the consult. 12% were followed by PADES (home care service) Miscellaneous group were 18%.
Conclusions: 1) In consults of our service it attends patients with high complexity. 2) Brief pursuit, in accordance with the complexity of population. 3) Good control of pain and depression in the second visit and this results remained in th next visit. 4) Long-term good control of anorexia and constipation.