Clinical outcomes of the best supportive care-clinic for patients with high grade glioma.

background and rationalePatients facing a new diagnosis of high-grade glioma may not be felt to benefit from active treatment after multidisciplinary team (MDT) review. Inadequate local knowledge may limit patient information provision and treatment refusal justification. A best supportive care-clinic (BSC-C) enables neurosurgical and clinical nurse specialist (CNS) review. This study assesses uptake and utility of the BSC-C, including appointment acceptance rates, onward referrals generated, and patient feedback.

methodsElectronic records between January and May 2024 of referrals to the BSC-C were retrospectively analysed. Data collected included demographics, diagnoses, time taken from presentation to diagnosis, diagnosis until BSC-C appointment date, content of BSC-C discussions, and follow-up.

resultsTwenty-nine patients were offered a BSC-C appointment between January and May 2024. Of these, 72.4% (n = 21) were accepted. Mean time from MRI diagnosis to an MDT decision was 11.8 days, and to a BSC-C appointment was 13.7 days. After the first appointment, a further 32 follow-up telephone calls were made across 15 patients (range 1-6 calls per patient). This resulted in 29 interventions made by the CNS, including palliative care referrals and changes to corticosteroid doses. A patient-reported feedback form indicated that patients benefitted from the clinic.

conclusionsThe BSC-C offers support to palliative neuro-oncology patients, who might otherwise be discharged to the community with little insight into their diagnosis or clinical advice on their symptom management. Appointments and follow-up calls are accepted by most patients, and offer both specialised advice, and a point-of-contact during a time of uncertainty.