Prospective Assessment of Symptom Palliation for Patients Attending a Rapid Response Radiotherapy Program

Chow, Edward; Wong, Rebecca; Connolly, R. C.; Hruby, George; Franzcr,; Franssen, Edmée; Fung, Kin Wah; Vachon, Mary L. S.; Andersson, L.; Pope, Joan; Holden, Lori; Szumacher, Ewa; Schueller, Trudi; Stefaniuk, Kim; Finkelstein, Joel; Hayter, Charles; Danjoux, Cyril

doi:10.1016/s0885-3924(01)00313-x

Cited by 33 publications

(40 citation statements)

References 19 publications

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“…More than 130 relevant articles and abstracts were identified, of which thirty-nine were primary studies published as complete peer-reviewed papers, representing 25 different institutions. Of the thirty-nine papers, thirteen were from Canada 6,11,[20][21][22][23][24][25][26][27][28][29][30] ; eight were from the United States [12][13][14]18,[31][32][33][34] ; eight were from Scandinavia (Sweden 15,[35][36][37] , Denmark [38][39] , Norway 40 , Finland 16 ); two were from Western Europe (Netherlands 41 , United Kingdom 42 ); five were from southern Europe (Switzerland 43 , Italy 17,[44][45][46] ); two were from Australia 47,48 ; and one was from Asia 49 .…”

Section: Methodsmentioning

confidence: 99%

“…Sample sizes in the thirty-three oncologic studies ranged from 32 to 1296 subjects, for a total in excess of 5000 patients. However, eleven of the thirty-three studies reported some data for the same patients: Sunnybrook Cancer Centre in Canada [25][26][27][28] , Bispebjerg Hospital in Denmark [38][39] , Linkoping Hospital in Sweden 15,35,36 , and Yale University 18,34 . For the patients described in the thirty-three papers, median age ranged from 53 to 74 years, and men were in a slight majority overall.…”

Section: Population Characteristicsmentioning

confidence: 99%

“…The overall distribution was perhaps typical of a palliative population. In the non-hospital but palliative context, most subjects were at home 17,18,22,[25][26][27][28][29][30]32,34,36,40,47 or at a hospice 48 . Overall, the "extreme" condition of the subjects is reflected in the descriptions provided in the papers themselves: disease was "advanced," patients were "terminally ill," symptoms were "moderate" to "severe" (justifying hospitalization), performance status was intermediate-to-low [median Karnofsky performance status (KPS): , and reduced cognitive functioning was present in some patients.…”

Section: Population Characteristicsmentioning

confidence: 99%

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A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

2009

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BackgroundSystematic symptom reporting by patients and the use of questionnaires such as the Edmonton Symptom Assessment System (ESAS) have potential to improve clinical encounters and patient satisfaction. We review findings from published studies of the ESAS to guide use of the system and to focus research. MethodsA systematic search for articles from 1991 through 2007 found thirty-nine peer-reviewed papers from 25 different institutions, thirty-three of which focused on patients with cancer. Observations, data, and statistics were collated according to relevance, reliability, validity, and responsiveness. ResultsFindings apply predominantly to symptomatic palliative patients with advanced cancer who were no longer receiving active oncologic therapies. Uncertainty about summarizing findings arises from frequent modification of the ESAS (altered items, scales, and time periods). Overall, reliability is established for daily administration. Scores are skewed, with a floor effect, but the relative order of symptoms by mean scores is similar across studies. Emotional symptoms are poorly captured by the depression and anxiety items. An equally weighted summation of scores may estimate a construct of "physical symptom distress," which in turn is related to performance status, palliative goals, quality of life, and well-being. ConclusionsThe ESAS is reliable, but it has restricted validity, and its use requires a sound clinical process to help interpret scores and to give them an appropriate level of attention. Research priorities are to further develop the ESAS for assessing a greater number of important physical symptoms (and to target "physical symptom

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Section: Methodsmentioning

confidence: 99%

Section: Population Characteristicsmentioning

confidence: 99%

Section: Population Characteristicsmentioning

confidence: 99%

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A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

2009

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“…A wait time of 7 days is recommended in patients with aggressive tumours and in some palliative patients 6 . Unfortunately, the delivery of timely palliative radiation therapy to patients in Ontario continues to be an issue of concern because of limitations in resources, equipment, and personnel 7 . And prolonged wait times are not an issue confined to Ontario; countries including England and Australia are dealing with the same problem 8 .…”

Section: Introductionmentioning

confidence: 99%

Continued Success in Providing Timely Palliative Radiation Therapy at the Rapid Response Radiotherapy Program: A Review of 2008–2012

et al. 2013

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Objective: We set out to review the Rapid Response Radiotherapy Program (rrrp). Methods: We retrospectively reviewed a prospective database of patients referred to the rrrp between August 1, 2008, and June 30, 2012, extracting patient demographics, case dispositions, and wait times in days from referral to consultation and from consultation to treatment. Results: Of 2742 patients referred to the rrrp, 1458 (53%) were men, and 1284 (47%) were women. Median age was 64 years. The most prevalent primary cancer sites were lung (33%), breast (21%), and prostate (17%). The most common reasons for referral were bone metastases (53%) and brain metastases (21%). Palliative radiation therapy was given to 1890 patients. The median wait time from referral to consultation was 3 days. Among treated patients, 60% were treated on the day of their consultation, and 33%, within 1–6 days. Conclusions: The rrrp continues to deliver timely palliative radiation therapy to patients, comparable to earlier reviews. The continued success of the rrrp will remain a model for future rapid-access palliative radiation therapy clinics.

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“…Multidisciplinary RRPC have shown to expedite patient's palliative radiotherapy both nationally and internationally 2, 9, 10. An assessment of the established RRPC at ROMC in 2005, showed patients referred to the RRPC waited less time to receive palliative radiotherapy compared with patients seen outside the RRPC 2.…”

Section: Introductionmentioning

confidence: 99%

Reducing radiotherapy waiting times for palliative patients: The role of the Advanced Practice Radiation Therapist

Job

Holt

Bernard

2017

J of Medical Radiation Sci

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IntroductionPalliative radiotherapy is effective in reducing symptom burden and improving quality of life in patients with symptomatic metastatic cancer and should be delivered in a timely manner. The aim of this study was to determine whether referring patients directly to a Palliative Advanced Practice Radiation Therapist (APRT) improves access to palliative radiotherapy and reduces time from referral to treatment.MethodsAt Radiation Oncology Mater Center (ROMC) in Brisbane, Australia a new referral pathway was developed which involved patients requiring palliative radiotherapy, being referred directly to the APRT from a single external hospital medical oncology and palliative care departments. Over a 5 months period, patient demographics and time in working days from referral to treatment were compared for consecutive palliative patients seen within our department. Patients were stratified by method of referral i.e. via the new referral pathway (NP) or via standard referral pathway (SP).ResultsBetween October 2014 and March 2015, a total of 150 patients were referred for palliative radiotherapy. Of these patients, 48 were referred and processed via the NP. There was a significant reduction in the number of days from referral to treatment for patients referred through the NP. Patients referred through the NP via the APRT had a mean and median wait time of 3.5 and 3 days respectively compared with 8.1 and 5 days for patients referred through the SP (P = <0.001). Patients were also more likely to have the treatment completed with less visits to the hospital (P < 0.001).ConclusionsThe new referral pathway utilising a dedicated palliative APRT decreased waiting times for patients receiving palliative radiotherapy and improved timely access to the radiotherapy service for both referrers and patients.

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Prospective Assessment of Symptom Palliation for Patients Attending a Rapid Response Radiotherapy Program

Cited by 33 publications

References 19 publications

A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

A Review of the Reliability and Validity of the Edmonton Symptom Assessment System

Continued Success in Providing Timely Palliative Radiation Therapy at the Rapid Response Radiotherapy Program: A Review of 2008–2012

Reducing radiotherapy waiting times for palliative patients: The role of the Advanced Practice Radiation Therapist

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