Year: 2016
Type: editorial
Abstract: Treatment-related symptoms are common among patients with metastatic cancer and can result in distress, decrements in physical function, and unplanned hospitalizations.1,2 Symptom management is a cornerstone of clinical practice, and both symptom management and quality of life are consistently among the highest priorities to patients with cancer and their caregivers.3,4 Typically, clinicians elicit symptom information at clinic visits through unstructured discussions.However, with this approach, care teams do not detect burdensome symptoms up to one half of the time, and clinicians' symptom ratings have low reliability.[5][6][7] Under detection of symptoms occurs for several reasons.Visits with clinicians may be too infrequent or too short to adequately capture symptom burden.Patients may have trouble recalling how frequent or burdensome their symptoms have been in between visits due to recall bias.8,9 Communication between clinicians and patients may be hampered by status and educational differences, language barriers, expectations about clinical encounters, lack of trust, not feeling well, and more.10,11 One solution is to systematically screen for symptoms between visits by asking patients to complete weekly patient-reported outcome (PRO) measures about their pain, nausea, and other symptoms.PRO measures are the preferred approach for assessing symptoms across health care contexts because patients are in the best position to report on their own experiences and because PROs provide a more comprehensive understanding of those experiences.12 Routine use of PROs has been identified as a priority area by the President's Cancer Panel and national oncology societies such as ASCO.13,14 However, health care systems lack roadmaps for how to change multiple system levels and infrastructures to integrate PRO measures into clinical workflow, which is an implementation problem.Thus, a critical need exists for comprehensive implementation strategies that address barriers and strengthen facilitators unique to each health care system.
Source: Journal of Oncology Practice
Authors: Angela M. Stover, Ethan M. Basch
Institution: University of North Carolina at Chapel Hill
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2517476863