Symptom and medication profiles among cancer patients attending a palliative care clinic

Riechelmann, Rachel P.; Krzyzanowska, Monika K.; O'Carroll, Aoife; Zimmermann, Camilla

doi:10.1007/s00520-007-0253-8

Cited by 109 publications

(98 citation statements)

References 22 publications

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“…Comparing our results to studies that specifically report ESAS scores from a palliative care unit or clinic, 26,27,[31][32][33][34][35][36][37][38] the symptom prevalence and symptom scores from these palliative patients are consistently higher than in our study. For example, in a study of 1296 patients attending a palliative radiation oncology outpatient clinic, 26 the median symptom score was 5 for fatigue, 2 for dyspnea, 3 for pain, and 2 for depression compared with our results of 3, 0, 1, and 0, respectively.…”

Section: Sarcomasupporting

confidence: 56%

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

197

128

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BACKGROUND. For ambulatory cancer patients, Ontario has standardized symptom and performance status assessment population-wide, using the Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS). In a broad cross-section of cancer outpatients, the authors describe the ESAS and PPS scores and their relation to patient characteristics. METHODS. This is a descriptive study using administrative healthcare data. RESULTS. The cohort included 45,118 and 23,802 patients' first ESAS and PPS, respectively. Fatigue was most prevalent (75%), and nausea least prevalent (25%) in the cohort. More than half of patients reported pain or shortness of breath; about half of those reported moderate to severe scores. Seventy-eight percent had stable performance status scores. On multivariate analysis, worse ESAS outcomes were consistently seen for women, those with comorbidity, and those with shorter survivals from assessment. Lung cancer patients had the worst burden of symptoms. CONCLUSIONS. This is the first study to report ESAS and PPS scores in a large, geographically based cohort with a full scope of cancer diagnoses, including patients seen earlier in the cancer trajectory (ie, treated for cure). In this ambulatory cancer population, the high prevalence of numerous symptoms parallels those reported in palliative populations and represents a target for improved clinical care. Differences in outcomes for subgroups require further investigation. This research sets the groundwork for future research on patient and provider outcomes using linked administrative healthcare data. Cancer 2010;116:5767-76.

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Section: Sarcomasupporting

confidence: 56%

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Barbera

Seow

Howell

et al. 2010

Cancer

197

128

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“…First, antidepressant use in our cancer study population (27.7%) was similar to antidepressant use in previous studies (10% to 34%) [11,239,[255][256][257][258][259][260][261][262]. Specifically, in breast cancer patients, 34.4% used antidepressants, which is consistent with the maximum reported percentage of breast cancer patients using antidepressants in previous studies (11% to 34%) [11,239,[255][256][257][258][259][260][261].…”

Section: Strengthssupporting

confidence: 88%

“…A systematic review reported the median prevalence of depression in advanced cancer patients was 29% using the Hospital Anxiety and Depression Scale [238], while another study found 57% of ambulatory palliative care cancer patients self-reported depression [239]. Depression was documented in as many as 46% of breast cancer patients [240,241], although this number was not as high in hematologic cancer patients (17.5%) [242].…”

Section: Antidepressant Usementioning

confidence: 99%

“…A waiting room sample of breast cancer patients revealed that 34% of the population was prescribed antidepressants [255]. Overall, rates of antidepressant use in breast cancer population ranged from 11% to 34% [11,239,[255][256][257][258][259][260][261]. Among patients diagnosed with melanoma, rates ranged from 10.1% to 24.9% [262], and 15% of NHL patients used tricyclic antidepressants [263].…”

Section: Antidepressant Usementioning

confidence: 99%

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Antidepressant use and risk of central nervous system metastasis

et al. 2016

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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%

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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Symptom and medication profiles among cancer patients attending a palliative care clinic

Cited by 109 publications

References 22 publications

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Symptom burden and performance status in a population‐based cohort of ambulatory cancer patients

Antidepressant use and risk of central nervous system metastasis

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

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