Cancer symptom scale preferences: does one size fit all?

Jeter, Kirby; Blackwell, Siobhan; Burke, Lucy; Joyce, David; Moran, Catherine; Conway, Emma Victoria; Cremen, Iseult; O’Connor, Brenda I.; Dhuibhir, Pauline Uí; Walsh, Declan

doi:10.1136/bmjspcare-2015-001018

Cited by 17 publications

(13 citation statements)

References 22 publications

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“…The vulnerability of our patients is also evident from the fact that about 40% of our patients were admitted via the emergency room or directly from home care, which suggests that a SIPC treatment was not proactively planned or not sufficient, but an emergency admission necessary. Other studies with potentially other admission policies report considerably lower ECOG performance status in oncology patients on a palliative care unit of ECOG 2 in median [34]. In contrast to MIDOS, IPOS assessment includes additional psychosocial problems with family or friends being anxious or worried about him/her, feeling anxious or worried about his/her illness or treatment, and feeling depressed.…”

Section: Discussionmentioning

confidence: 99%

Systematic symptom and problem assessment at admission to the palliative care ward – perspectives and prognostic impacts

et al. 2020

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Background: Symptom assessment is essential in palliative care, but holds challenges concerning implementation and relevance. This study aims to evaluate patients' main symptoms and problems at admission to a specialist inpatient palliative care (SIPC) ward using physician proxy-and patient self-assessment, and aims to identify their prognostic impact as well as the agreement between both assessments. Methods: Within 12 h after admission, palliative care specialists completed the Symptom and Problem Checklist of the German Hospice and Palliative Care Evaluation (HOPE-SP-CL). Patients either used the new version of the minimal documentation system for patients in palliative care (MIDOS) or the Integrated Palliative Care Outcome Scale (IPOS) plus the Distress Thermometer (DT). Results: Between 01.01.2016-30.09.2018, 1206 patients were included (HOPE-SP-CL 98%; MIDOS 21%, IPOS 34%, DT 27%) whereof 59% died on the ward. Proxy-assessment showed a mean HOPE-SP-CL Total Score of 24.6 ± 5.9 of 45. Most frequent symptoms/problems of at least moderate intensity were weakness (95%), needs of assistance with activities of daily living (88%), overburdening of family caregivers (83%), and tiredness (75%). Factor analysis identified four symptom clusters (SCs): (1) Deteriorated Physical Condition/Decompensation of Home Care, (2) Emotional Problems, (3) Gastrointestinal Symptoms and (4) Other Symptoms. Self-assessment showed a mean MIDOS Total Score of 11.3 ± 5.3 of 30, a mean IPOS Total Score of 32.0 ± 9.0 of 68, and a mean distress of 6.6 ± 2.5 of 10. Agreement of self-and proxy-assessment was moderate for pain (ƙ = 0.438) and dyspnea (ƙ = 0.503), fair for other physical (ƙ = 0.297 to 0.394) and poor for psychological symptoms (ƙ = 0.101 to 0.202). Multivariate regression analyses for single symptoms and SCs revealed that predictors for dying on the SIPC ward included impaired ECOG performance status, moderate/severe dyspnea, appetite loss, tiredness, disorientation/confusion, and the SC Deteriorated Physical Condition/Decompensation of Home Care.

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Section: Discussionmentioning

confidence: 99%

Systematic symptom and problem assessment at admission to the palliative care ward – perspectives and prognostic impacts

et al. 2020

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“…However, sensory‐compromised situations, most often associated with taste and smell dysfunctionality are not confined to the elderly. Multiple aetiologies, including chemotherapy for cancer (Murtaza et al ., ; Jeter et al ., ), Alzheimer's disease (Sergi et al ., ; Boesveldt et al ., ), sinonasal disease and anosmia (Whitcroft et al ., ), can lead to poor appetite and potential malnutrition. Furthermore, cancer associated cachexia patients (Werner et al ., ; Baracos et al ., ; Crawford, ), could significantly benefit from development of high‐nutrient functional food products with soft texture characteristics as an aid to ease swallowing.…”

Section: Discussionmentioning

confidence: 99%

Ensuring the future of functional foods

Birch

Bonwick

2018

Int J of Food Sci Tech

129

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Consumption of functional foods suggests a strategy to reduce the incidence of chronic health disorders. This message has resonated with consumers and driven market growth. Functional food research has significantly increased over the last decade but few studies have addressed the bioavailability of active ingredients for clinical efficacy. Baked goods such as bread, biscuits and cake are popular categories for innovation due to their widespread consumption. These new developments have often impacted on organoleptic properties of the finished products and thus consumer acceptance. Blending of bioactive ingredients may overcome this deficit. However, an understanding of the role of the microbiome in health has indicated that the efficacy of functional foods is unlikely to be uniform within the population. Further growth in the functional foods market, is likely to require greater evidence of the bioavailability of active ingredients, clinical effect and support for health claims by regulators especially in the EU.

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“…The NRS used in E2C2 to assess the SPADE symptoms and physical function will be patterned on the extensively validated MD Anderson Symptom Inventory and the Edmonton Symptom Assessment System for the 24-h recall period and the verbal anchors (e.g. from no pain to worst possible pain) [84,85], NRSs have been shown to be more responsive than either Likert or verbal rating scales [86] and to be preferred by patients over visual analogue scales [87].…”

Section: Primary Outcomesmentioning

confidence: 99%

Pragmatic cluster randomized trial to evaluate effectiveness and implementation of enhanced EHR-facilitated cancer symptom control (E2C2)

Rutten

Ruddy

Chlan

et al. 2020

Trials

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Background: The prevalence of inadequate symptom control among cancer patients is quite high despite the availability of definitive care guidelines and accurate and efficient assessment tools. Methods: We will conduct a hybrid type 2 stepped wedge pragmatic cluster randomized clinical trial to evaluate a guideline-informed enhanced, electronic health record (EHR)-facilitated cancer symptom control (E2C2) care model. Teams of clinicians at five hospitals that care for patients with various cancers will be randomly assigned in steps to the E2C2 intervention. The E2C2 intervention will have two levels of care: level 1 will offer low-touch, automated self-management support for patients reporting moderate sleep disturbance, pain, anxiety, depression, and energy deficit symptoms or limitations in physical function (or both). Level 2 will offer nurse-managed collaborative care for patients reporting more intense (severe) symptoms or functional limitations (or both). By surveying and interviewing clinical staff, we will also evaluate whether the use of a multifaceted, evidence-based implementation strategy to support adoption and use of the E2C2 technologies improves patient and clinical outcomes. Finally, we will conduct a mixed methods evaluation to identify disparities in the adoption and implementation of the E2C2 intervention among elderly and rural-dwelling patients with cancer. Discussion: The E2C2 intervention offers a pragmatic, scalable approach to delivering guideline-based symptom and function management for cancer patients. Since discrete EHR-imbedded algorithms drive defining aspects of the intervention, the approach can be efficiently disseminated and updated by specifying and modifying these centralized EHR algorithms.

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Cancer symptom scale preferences: does one size fit all?

Cited by 17 publications

References 22 publications

Systematic symptom and problem assessment at admission to the palliative care ward – perspectives and prognostic impacts

Systematic symptom and problem assessment at admission to the palliative care ward – perspectives and prognostic impacts

Ensuring the future of functional foods

Pragmatic cluster randomized trial to evaluate effectiveness and implementation of enhanced EHR-facilitated cancer symptom control (E2C2)

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