Diana N Naehrig1,2, Haryana M Dhillon3, Rebecca Asher4, Peter Grimison2,5, Suzanne Grant1,6, Judith Lacey7,8,9. 1. Department of Integrative Oncology and Supportive Care, Chris O'Brien Lifehouse Comprehensive Cancer Centre, 119-143 Missenden Road, Camperdown, Sydney, 2050, NSW, Australia. 2. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. 3. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, The University of Sydney, Sydney, Australia. 4. NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia. 5. Department of Medical Oncology, Chris O'Brien Lifehouse Comprehensive Cancer Centre, Sydney, Australia. 6. NICM Health Research Institute, Western Sydney University, Sydney, 2145, NSW, Australia. 7. Department of Integrative Oncology and Supportive Care, Chris O'Brien Lifehouse Comprehensive Cancer Centre, 119-143 Missenden Road, Camperdown, Sydney, 2050, NSW, Australia. judith.lacey@lh.org.au. 8. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. judith.lacey@lh.org.au. 9. NICM Health Research Institute, Western Sydney University, Sydney, 2145, NSW, Australia. judith.lacey@lh.org.au.
Abstract
PURPOSE: Patient-reported outcome measures (PROMs) are useful clinical tools to recognise symptoms, patient needs and their severity. Whilst PROMs are routinely utilised in integrative oncology (IO) and supportive care (SC) services to improve patient care, they are not as common in general oncology. We explored our patients' symptom burden, the approach taken by clinicians to identify and manage patient needs, and barriers and facilitators to using PROMs in an Australian tertiary comprehensive cancer centre to inform wider implementation of PROMs. METHODS: From 2017 to 2018, PROM data collected for patients accessing IO and SC was retrospectively analysed. Semi-structured interviews with oncology doctors and nurses explored their approach to patient needs assessment and their use of PROMs. RESULTS: A total of 404 patients completed the Edmonton Symptom Assessment Scale (ESAS). The most frequently identified symptoms were sleep disturbance, fatigue and lack of wellbeing. Symptom clusters included drowsiness, fatigue and shortness of breath; anxiety and depression; sleep and pain; appetite and nausea. In total, 9 nurse consultants, 5 surgeons, 7 medical and 5 radiation oncologists were interviewed. Most participants took an intuitive approach to identifying and managing patient needs and did not routinely use PROMs. Perceived risks, barriers and facilitators to using PROMS are presented. CONCLUSIONS: High and complex symptom burden was found in our IO and SC patient population, reinforcing the need for screening. Whilst wider clinical use of PROMs within the hospital may improve clinical outcomes, the barriers and facilitators identified by Health Care Professionals (HCPs) need to be addressed before implementing PROMs more broadly.
PURPOSE:Patient-reported outcome measures (PROMs) are useful clinical tools to recognise symptoms, patient needs and their severity. Whilst PROMs are routinely utilised in integrative oncology (IO) and supportive care (SC) services to improve patient care, they are not as common in general oncology. We explored our patients' symptom burden, the approach taken by clinicians to identify and manage patient needs, and barriers and facilitators to using PROMs in an Australian tertiary comprehensive cancer centre to inform wider implementation of PROMs. METHODS: From 2017 to 2018, PROM data collected for patients accessing IO and SC was retrospectively analysed. Semi-structured interviews with oncology doctors and nurses explored their approach to patient needs assessment and their use of PROMs. RESULTS: A total of 404 patients completed the Edmonton Symptom Assessment Scale (ESAS). The most frequently identified symptoms were sleep disturbance, fatigue and lack of wellbeing. Symptom clusters included drowsiness, fatigue and shortness of breath; anxiety and depression; sleep and pain; appetite and nausea. In total, 9 nurse consultants, 5 surgeons, 7 medical and 5 radiation oncologists were interviewed. Most participants took an intuitive approach to identifying and managing patient needs and did not routinely use PROMs. Perceived risks, barriers and facilitators to using PROMS are presented. CONCLUSIONS: High and complex symptom burden was found in our IO and SC patient population, reinforcing the need for screening. Whilst wider clinical use of PROMs within the hospital may improve clinical outcomes, the barriers and facilitators identified by Health Care Professionals (HCPs) need to be addressed before implementing PROMs more broadly.
Authors: Reza Hajialibeigloo; Yaser Moradi; Hossein Habibzadeh; Rahim Baghaei; Vahid Alinejad; Mohammad Namazi Nia Journal: Health Qual Life Outcomes Date: 2022-01-29 Impact factor: 3.186