Quality Improvement in Cancer Symptom Assessment and Control: The Provincial Palliative Care Integration Project (PPCIP)

Gilbert, Julie; Howell, Doris; King, Susan; Sawka, Carol; Hughes, Erin; Angus, Helen; Dudgeon, Deborah

doi:10.1016/j.jpainsymman.2011.04.028

Cited by 82 publications

(87 citation statements)

References 26 publications

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“…Myoclonus may develop in response to infection, head or spinal cord injury, stroke, stress, brain tumors, kidney or liver failure, lipid storage disease, chemical or drug poisoning, as a side effect of certain drugs, particularly opioids and anticholinergics [6,8,16], or other disorders [8]. Sweating allows the body to regulate its temperature.…”

Section: Discussionmentioning

confidence: 99%

“…The most popular and validated tool for symptom assessment is the Edmonton Symptom Assessment System [3,13,14]. Implementation of the ESAS provided improvements in symptom screening, symptom control, and functional assessment [6]. However, there is a group of symptoms which is seldom evaluated in most symptom assessment tools [5], and can be considered as orphan symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Orphan symptoms in advanced cancer patients followed at home

Mercadante¹,

Porzio²,

Valle³

et al. 2013

Support Care Cancer

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Orphan symptoms are rarely assessed, particularly at home. The aim of this multicenter prospective study was to assess the prevalence of these symptoms and eventual factors possibly associated in advanced cancer patients at admission of a home care program. A prospective study was performed at three home care programs in Italy. Patients' data were collected, including age, sex, diagnosis, and Karnofsky status. Possible contributing factors were analyzed; preexisting neurological diseases, cerebral metastases, hyperthermia, diabetes, a state of dehydration clinically evident and/or oliguria, possible biochemical parameters when available, data regarding recent chemotherapy, opioids and doses, use of neuroleptics, benzodiazepine or anticonvulsants, corticosteroids, anti-inflammatory, and antibiotics were collected.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Orphan symptoms in advanced cancer patients followed at home

Mercadante¹,

Porzio²,

Valle³

et al. 2013

Support Care Cancer

View full text Add to dashboard Cite

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“…[20][21][22][23] To date, most PROMs have been implemented as a rapid screening maneuver using brief, single dimension severity scales such as the Distress Thermometer or the Edmonton Symptom Assessment System (ESAS). 24,25 Unidimensional measures do not capture the multidimensional nature of these problems and thus may lack precision in estimating severity and detecting responsiveness to change in individuals. 26,27 Patients and clinicians would benefit from PROMs that are useful for routine surveillance of CRF and sleep disturbance while not being burdensome, which can guide intervention selection in routine cancer practice.…”

Section: Accepted Articlementioning

confidence: 99%

Feasibility and diagnostic accuracy of the Patient‐Reported Outcomes Measurement Information System (PROMIS) item banks for routine surveillance of sleep and fatigue problems in ambulatory cancer care

Leung

Brown

Cosio

et al. 2016

Cancer

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This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version record. Please cite this article as doi:10.1002/cncr.30134.This article is protected by copyright. All rights reserved. Accepted Article2 of the study, ethics application, recruitment, data management), Dobriyal A (conceptualization of the study, recruitment), Malik N (conceptualization of the study, recruitment, data collection), Pat V (recruitment, data collection, data analysis), Irwin M (recruitment, data management, data analysis), Tomasini P (conceptualization of the study, recruitment, data collection, data analysis), Liu G ( There is no conflict of interest declared. Page 2 of 44 CancerThis article is protected by copyright. All rights reserved. Accepted Article 3Abstract (word limit: 250; word count: 246)

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“…Recent studies have shown significant benefits to early introduction of palliative care and better end-of-life care in terms of survival [30], quality of life [31], and aggressiveness of care in patients with end-stage cancer [32]. In response, both Canada and the U.S. have identified end-of-life care as an important target for quality improvement, with significant efforts in both countries to improve quality of end-of-life care that focuses on systematic and comprehensive symptom management [33] and on integration of early palliative care input in a standardized way [34].…”

Section: International Experiencementioning

confidence: 99%

Responding to Acute Care Needs of Patients With Cancer: Recent Trends Across Continents

et al. 2016

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Remarkable progress has been made over the past decade in cancer medicine. Personalized medicine, driven by biomarker predictive factors, novel biotherapy, novel imaging, and molecular targeted therapeutics, has improved outcomes. Cancer is becoming a chronic disease rather than a fatal disease for many patients. However, despite this progress, there is much work to do if patients are to receive continuous highquality care in the appropriate place, at the appropriate time, and with the right specialized expert oversight. Unfortunately, the rapid expansion of therapeutic options has also generated an ever-increasing burden of emergency care and encroaches into end-of-life palliative care. Emergency presentation is a common consequence of cancer and of cancer treatment complications. It represents an important proportion of new presentations of previously undiagnosed malignancy. In the U.K. alone, 20%-25% of new cancer diagnoses are made following an initial presentation to the hospital emergency department, with a greater proportion in patients older than 70 years. This late presentation accounts for poor survival outcomes and is often associated with poor patient experience and poorly coordinated care.The recent development of acute oncology services in the U.K. aims to improve patient safety, quality of care, and the coordination of care for all patients with cancer who require emergency access to care, irrespective of the place of care and admission route. Furthermore, prompt management coordinated by expert teams and access to protocol-driven pathways have the potential to improve patient experience and drive efficiency when services are fully established. The challenge to leaders of acute oncology services is to develop bespoke models of care, appropriate to local services, but with an opportunity for acute oncology teams to engage cancer care strategies and influence cancer care and delivery in the future. This will aid the integration of highly specialized cancer treatment with high-quality care close to home and help avoid hospital admission. The Oncologist 2016;21:301-307 Implications for Practice: Emergency presentations of cancer patients to health care services can be associated with high risks and poor outcomes. Systematic approaches are described to create best practice for these patients based on expert teams and careful organization of services in all hospitals. These approaches, called "acute oncology" in the U.K., may improve care and avoid unnecessary deaths.

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Quality Improvement in Cancer Symptom Assessment and Control: The Provincial Palliative Care Integration Project (PPCIP)

Cited by 82 publications

References 26 publications

Orphan symptoms in advanced cancer patients followed at home

Orphan symptoms in advanced cancer patients followed at home

Feasibility and diagnostic accuracy of the Patient‐Reported Outcomes Measurement Information System (PROMIS) item banks for routine surveillance of sleep and fatigue problems in ambulatory cancer care

Responding to Acute Care Needs of Patients With Cancer: Recent Trends Across Continents

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