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E mergency department (ED) use and hospitalization across the continuum of cancer treatment are common and distressing issues for patients and their families. Use of these services is recognized as an indicator of poor quality end-oflife care, but studies have demonstrated frequent use of them in patients with advanced cancer and particularly in those who are close to the end of life. Tere is growing evidence that more than 50% of ED visits are secondary to cancer symptoms and that nearly 23% of visits could be avoided. Early identifcation of these patients and aggressive outpatient symptom management may reduce ED use and hospitalization. Tis improved quality of care could also have a positive impact on the high cost of end-of-life cancer care. Diferent models of care have been explored to provide outpatient supportive treatment to cancer patients, including nurse practitioner (NP)-driven symptom management clinics. In this study, we explored the characteristics of high users of emergency department services and the impact of an NP-led, physician-supervised, symptom management clinic on the total frequency of emergency department visits.

The impact of a nurse practitioner-led symptom clinic on emergency department use in cancer patients