Systematic self-reporting of patients’ symptoms: improving oncologic care and patients’ satisfaction

Abstract

Background: In recent years, there has been a growing interest to enhance patients’ symptom management during routine cancer care using patient-reported outcome measures. The goal of this study is to analyse patients’ responses to the Edmonton Symptom Assessment System (ESAS) to determine whether patient-reported outcomes could help characterise those patients with the highest supportive care needs and symptom burden in order to help provide targeted support for patients. Methods: In this study, we analysed ESAS questionnaire responses completed by patients as part of their routine care and considered part of patients’ standard of care. Statistical analyses were performed using the IBM SPSS Statistics version 26.0. Descriptive statistics are used to summarise patient demographics, disease characteristics and patient-reported symptom severity and prevalence. Results: The overall mean age is 65.2 ± 12.8 years comprising 43.8% male and 56.2% female patients. The five common primary disease sites are breast (26.2%), haematology (21.1%), gastrointestinal (15.3%), genitourinary (12.7%) and lung (12.0%) cancers. The mean severity for each symptom is all mild (score: 1–3). The three most common reported symptoms causing distress are tiredness, poor overall wellbeing and anxiety, and the least reported symptom is nausea. Conclusions: Systematic self-reporting of patients’ symptoms is important to improve symptom management, timely facilitation of appropriate intervention, patient experience, and patient and family satisfaction. The awareness of disease site, gender and age-related symptom variations should help in the design and provision of appropriate symptom-directed, tumour-specific and patient-focused interventions to meet patients’ immediate needs.

Patients’ self-reported overall wellbeing correlates with concurrent reported symptoms: analysis of the Edmonton Symptom Assessment System

“…These observations are consistent with similar studies that have been reported in the literature. 9,44,62–64 Yennurajalingam et al 44 used the ESAS patient-reported outcome questionnaire to investigate factors associated with a feeling of wellbeing among 826 advanced lung or non-colonic gastrointestinal cancer patients and observed that patient-reported wellbeing was significantly associated with tiredness. Wilding et al 63 also investigated the associations between cancer-related symptoms, health-related quality of life and poor psychological outcomes in 13,097 prostate cancer patients treated with androgen deprivation therapy (ADT) and reported that clinically significant tiredness was strongly associated with poor wellbeing in patients.…”

“…These observations are consistent with other similar studies that have been reported in the literature. 9,23,44,45,62–64…”

“…It is a validated standardised patient-centred symptom assessment tool that is used to evaluate the severity of six physical and two psychological symptoms of distress as well as overall wellbeing related to cancer. 8,9,12–42…”

“…Understanding patients' wellbeing from the patient's perspective is essential as it could help enable the provision of the necessary support for patients throughout their cancer journey. Consequently, several patient-reported outcome tools such as the Symptom Distress Scale (SDS), [2][3][4] the Hospital Anxiety and Depression Scale (HADS) [5][6][7] and the Edmonton Symptom Assessment Scale (ESAS) [8][9][10][11] have become a valuable method for patients to effectively communicate the adverse effects they are experiencing and their overall wellbeing to their healthcare providers. The ESAS is used for self-assessment and evaluation of cancer symptom burden and captures information about nine common symptoms experienced by cancer patients including their overall wellbeing.…”

“…It is a validated standardised patient-centred symptom assessment tool that is used to evaluate the severity of six physical and two psychological symptoms of distress as well as overall wellbeing related to cancer. 8,9, The scoring of patient symptom burden using patient-reported outcomes is very subjective, and several studies have attempted to identify associations between the significance of the numerical symptom scores and various thresholds for intervention. 16,22,43 McKenzie et al 16 used the ESAS responses to characterise the relationship between dyspnoea (i.e., shortness of breath), and concurrent symptoms experienced by advanced cancer patients.…”