Implementation of distress screening in an oncology setting

Abstract

The recommendations of numerous groups, such as the Institute of Medicine and the National Comprehensive Cancer Network, have resulted in the first regulatory standard on distress screening in oncology implemented in 2015 by the American College of Surgeons Commission on Cancer. This practice-changing standard promises to result in better quality cancer care, but presents unique challenges to many centers struggling to provide high-quality practical assessment and management of distress. The current paper reviews the history behind the CoC standard, identifies the most prevalent symptoms underlying distress, and discusses the importance of distress screening. We also review some commonly used instruments for assessing distress, and address barriers to implementation of screening and management.

Validity and usefulness of a single‐item measure of patient‐reported bother from side effects of cancer therapy

“…The increasing efficacy of cancer treatment has resulted in an increasing array of treatment‐related symptoms and associated burdens imposed on individuals undergoing aggressive treatment of their disease. Patients treated aggressively with chemotherapy are at risk of a host of treatment‐related side effects such as nausea, fatigue, depression, diarrhea, and declines in overall physical functioning . Some persistent side effects, such as peripheral neuropathy, have been found to increase health care costs and resource use .…”

“…Patients treated aggressively with chemotherapy are at risk of a host of treatment-related side effects such as nausea, fatigue, depression, diarrhea, and declines in overall physical functioning. 3 Some persistent side effects, such as peripheral neuropathy, have been found to increase health care costs and resource use. 4 In addition, in cases in which treatment demands extend into years rather than months, avoiding toxicity may be a more relevant outcome than more traditional outcomes such as response rate or progression-free survival.…”

Establishing a common metric for self‐reported anxiety in patients with prostate cancer: Linking the Memorial Anxiety Scale for Prostate Cancer with PROMIS Anxiety

“…Interest in their use in oncology applications, including routine clinical care 2 and quality improvement, also is growing. 3,4 For example, PROs are being increasingly administered in clinical care settings to gather and track serial data that can be used in distress screening, 5 the prediction of treatment discontinuation, 6 and risk adjustment modeling. 7 Measuring clinical care performance and patient satisfaction is another emerging area in which PROs may be useful.…”

Responding to the quality imperative to embed mental health care into ambulatory oncology

“…Several cancer centers across the United States have incorporated e‐health and EHR‐based distress screening solutions for their oncology patients that are based on patient portals and/or EHR platforms with real‐time assessment, scoring, and triaging. One successful example of EHR integration is the Lurie Screening Initiative of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University . The Lurie Screening Initiative addresses and surpasses the requirements of the CoC standard for psychosocial screening and referral to psychosocial care.…”

“…One successful example of EHR integration is the Lurie Screening Initiative of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. 25,26 The Lurie Screening Initiative addresses and surpasses the requirements of the CoC standard for psychosocial screening and referral to psychosocial care. The Cancer Survivorship Institute and the Cancer Control and Survivorship Research and Supportive Oncology programs have joined efforts to develop and implement PRO symptom assessments with PROMIS CAT measures.…”