Outpatient clinics are increasingly being recognized for their critical role in facilitating early palliative care access. This systematic review highlighted the lack of consensus in the literature on which patients should be referred in the ambulatory setting. Cancer diagnosis, prognosis, physical symptoms, performance status, psychosocial distress, and end-of-life care planning needs may be taken into consideration when appropriate candidates are being identified.
During the past several years, the MEDD prescribed by referring oncologists has decreased. After hydrocodone reclassification, the use of tramadol with less stringent prescription limits has increased.
Our panelists favored the combination of automatic referral to augment clinician-based referral. This integrated referral framework may inform policy and program development.
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