Lynn F Reinke1, Laura C Feemster2, Leah M Backhus3, Ina Gylys-Colwell4, David H Au2. 1. Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA Department of Biobehavioral Nursing and Health Systems, University of Washington, School of Nursing, Seattle, WA, USA reinkl@uw.edu. 2. Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA Pulmonary and Critical Care Medicine Division, University of Washington, School of Medicine, Seattle, WA, USA. 3. Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA University of Washington, School of Surgery, Cardiothoracic Surgery Division, Seattle, WA, USA. 4. Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA.
Abstract
RATIONALE: Little is known about symptom assessment around the time of lung cancer diagnosis. The purpose of this pilot study was to assess symptoms within 2 months of diagnosis and the frequency with which clinicians addressed symptoms among a cohort of veterans (n = 20) newly diagnosed with lung cancer. We administered questionnaires and then reviewed medical records to identify symptom assessment and management provided by subspecialty clinics for 6 months following diagnosis. RESULTS: Half (50%) of the patients were diagnosed with early-stage non-small-cell lung cancer (NSCLC), stage I or II. At baseline, 45% patients rated their overall symptoms as severe. There were no significant differences in symptoms among patients with early- or late-stage NSCLC or small-cell lung cancer. Of the 212 clinic visits over 6 months, 70.2% occurred in oncology. Clinicians most frequently addressed pain although assessment differed by clinic. CONCLUSIONS: Veterans with newly diagnosed lung cancer report significant symptom burden. Despite ample opportunities to address patients' symptoms, variations in assessment exist among subspecialty services. Coordinated approaches to symptom assessment are likely needed among patients newly diagnosed with lung cancer.
RATIONALE: Little is known about symptom assessment around the time of lung cancer diagnosis. The purpose of this pilot study was to assess symptoms within 2 months of diagnosis and the frequency with which clinicians addressed symptoms among a cohort of veterans (n = 20) newly diagnosed with lung cancer. We administered questionnaires and then reviewed medical records to identify symptom assessment and management provided by subspecialty clinics for 6 months following diagnosis. RESULTS: Half (50%) of the patients were diagnosed with early-stage non-small-cell lung cancer (NSCLC), stage I or II. At baseline, 45% patients rated their overall symptoms as severe. There were no significant differences in symptoms among patients with early- or late-stage NSCLC or small-cell lung cancer. Of the 212 clinic visits over 6 months, 70.2% occurred in oncology. Clinicians most frequently addressed pain although assessment differed by clinic. CONCLUSIONS: Veterans with newly diagnosed lung cancer report significant symptom burden. Despite ample opportunities to address patients' symptoms, variations in assessment exist among subspecialty services. Coordinated approaches to symptom assessment are likely needed among patients newly diagnosed with lung cancer.
Authors: Jaclyn Yoong; Elyse R Park; Joseph A Greer; Vicki A Jackson; Emily R Gallagher; William F Pirl; Anthony L Back; Jennifer S Temel Journal: JAMA Intern Med Date: 2013-02-25 Impact factor: 21.873
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