• Michael Rabow, Elizabeth Kvale, Lisa Barbour, J Brian Cassel, Susan Cohen, Vicki Jackson, Carol Luhrs, Vincent Nguyen, Simone Rinaldi, Donna Stevens, Lynn Spragens, and David Weissman.
• 1 Department of Internal Medicine, University of California , San Francisco, California.
• J Palliat Med. 2013 Dec 1;16(12):1540-9.

BackgroundThere is good evidence for the efficacy of inpatient palliative care in improving clinical care, patient and provider satisfaction, quality of life, and health care utilization. However, the evidence for the efficacy of nonhospice outpatient palliative care is less well known and has not been comprehensively reviewed.ObjectiveTo review and assess the evidence of the impact of outpatient palliative care.MethodsOur study was a review of published, peer-reviewed outcomes research, including both observational studies and controlled trials of nonhospice outpatient palliative care services. We assessed patient, family caregiver, and clinician satisfaction; clinical outcomes including symptom management, quality of life, and mortality; and heath care utilization outcomes including readmission rates, hospice use, and cost.ResultsFour well-designed randomized interventions as well as a growing body of nonrandomized studies indicate that outpatient palliative care services can: 1) improve patient satisfaction, 2) improve symptom control and quality of life, 3) reduce health care utilization, and 4) lengthen survival in a population of lung cancer patients.ConclusionsThe available evidence supports the ongoing expansion of innovative outpatient palliative care service models throughout the care continuum to all patients with serious illness.

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