Advanced age is one of the major determinants of frailty in patients with cancer-associated thrombosis. However, multiple other factors contribute to frailty in these patients. The identification of frailty in patients with cancer-associated thrombosis is critical as it influences the complexity of the anticoagulant treatment in this population at high risk of venous thromboembolism and bleeding. Factors that contribute to frailty in patients with cancer-associated thrombosis include age, type of cancer, comorbidities such as chronic kidney disease, poly-pharmacotherapy, treatment compliance, cognitive impairment, anemia, thrombocytopenia, mobility, nutritional status, Eastern Cooperative Oncology Group grade, risk of falls, and reduced life expectancy. In the absence of specific clinical studies current anticoagulant treatment guidelines for the management are not fully applicable to frail patients with cancer. The anticoagulant treatment should therefore benefit from a tailored approach based on an algorithm that takes into account the specificities of the malignant disease.
ObjectivesPatients’ needs are still underestimated during the course of cancer. The development of a simple and accessible screening tool to screen supportive care needs is an innovative approach to improve the cancer care pathway. The Supportive Care sCore (SCC) is a new tool developed to trigger alerts on the main supportive care needs, such as social, nutritional, physical, pain or psychological disorders. We aimed to develop and validate the SCC tool in identifying supportive care needs.MethodsThe SCC, the Edmonton Symptom Assessment System (ESAS) and the EuroQol-5 Dimension (EQ-5D) questionnaire (for quality of life) were distributed to patients with cancer over a week in an ambulatory hospital of an oncology department. Acceptability was measured by assessing the fill rate. Validity of alerts generated by the SCC was assessed by their consistency with the ESAS and EQ-5D scores.ResultsOne hundred patients were included, with an average age of 67.2 years. Acceptability was good with a fill rate of over 90%. For a priori-defined risk groups by SCC with alert or not, the ESAS symptom score and quality of life differed significantly (p<0.05) between groups. We observed higher ESAS symptom scores in the alert group (nutritional alert-appetite: 4 (SD 2.4) vs 0 (SD 2.6), p<0.001; physical alert-fatigue: 4 (SD 1.7) vs 2 (SD 2.2), p<0.001; psychological alert-depressed: 3.5 (SD 2.7) vs 0 (SD 1.5), p<0.001). Quality of life was poorer in each domain of the EQ-5D in the alert group.ConclusionsOur study demonstrates the construct validity of SCC, which holds promise in identifying supportive care needs.
e14025 Background: Patients’ needs are still underestimated during cancer course. The development of a simple and accessible screening tool to identify supportive care needs is an innovative approach to improve the cancer care pathway. Supportive Scale sCore (SCC) is a new tool developed to trigger alert in main need of supportive care such as social, nutritional, physical, pain or psychological disorders. This study aimed to develop and validate the SCC tool for detecting supportive care needs. Methods: The SCC, the Edmonton Symptom Assessment System (ESAS), a symptom scale and the EQ-5D (for Quality Of Life) was distributed to cancer patients over a week, in an ambulatory hospital of oncology department. The acceptability was assessed by the fill rate. The validity of alerts generated by the SCC scale was assessed by their consistency with ESAS and EQ-5D scores. Results: Hundred patients were included with an average age of 67,2 years. Acceptability was good with a fill rate of over 90%. For a-priori defined risk groups by SCC with alert or not, ESAS symptom score and QOL differed significantly (p < 0,05) between groups. We observed higher ESAS symptom scores in the alert group [nutritional alert: appetite: 4 (Standard Deviation SD 2,4) vs 0 (SD 1,6), p < 0,001; physical alert: fatigue: 4 (SD 1,7) vs 2 (SD 2,2) p < 0,001; psychological alert: depressed: 3,5 (SD 2,7) vs 0 (SD 1,5), p < 0,001; anxiety: 4 (SD 2,9) vs 0 (SD 1,5), p < 0,001; unwell-being: 4,5 (SD 2,7) vs. 0 (SD 1,5), p < 0,001]. Moreover, the QOL was poorer in each domain of EQ-5D in the alert group. [Social alert, self-care: 9,3% vs 0%, p = 0,02; usual activities: 25% vs 5,4%, p = 0,005. Physical alert, usual activities: 21,3% vs 2,6%, p = 0,008; mobility 29,5% vs 2,6%, p = 0,01. Pain alert, pain: 81,8% vs 11,9%, p < 0,001. Psychological alert, psychological: 56,3% vs 11,9%, p < 0,001]. Conclusions: The SCC seems to be a reliable instrument to detect cancer patients’ supportive care needs.
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