Patient-reported symptom burden and supportive care needs at cancer diagnosis: a retrospective cohort study

• Published in: Supportive care in cancer Vol. 28; no. 12; pp. 5889 - 5899
• Main Authors: Cuthbert, Colleen A., Boyne, Devon J., Yuan, Xu, Hemmelgarn, Brenda R., Cheung, Winson Y.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2020; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Alberta; Anxiety; Anxiety - psychology; Cancer; Cohort analysis; Cohort Studies; Comorbidity; Development and progression; Diagnosis; Fatigue - psychology; Female; Health aspects; Humans; Male; Medical diagnosis; Medicine; Medicine & Public Health; Mental health; Middle Aged; Needs analysis; Neoplasms - diagnosis; Neoplasms - pathology; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Patient assessment; Patient Reported Outcome Measures; Patients; Prevalence; Rehabilitation Medicine; Retrospective Studies; Social support; Surveys and Questionnaires; Symptom Assessment - methods; Well being; Young Adult; Alberta; Canada; Symptom prevalence; Supportive care needs; Patient-reported outcomes; Symptom burden
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-020-05415-y

Purpose Patient-reported outcomes (PROs) are used to assess patients’ symptoms and supportive care needs. While PROs are increasingly employed in clinical practice, research utilizing these data remains limited. Our goal was to evaluate PROs from a provincial cancer program. Methods A retrospective, population-based cohort study using administrative health data of patients in Alberta, Canada, diagnosed with cancer between January 1, 2016, and October 23, 2017. Adults who completed PROs (Edmonton Symptom Assessment System, ESAS) and supportive care needs inventory (Canadian Problem Checklist)) within ± 60 days of diagnosis were included. Patients were stratified by tumor types (breast, colorectal, lung, prostate, hematological, or other). Descriptive statistics were used to characterize symptom burden and supportive care needs. Multivariate logistic regression was used to evaluate factors associated with higher symptom severity. Results We included 1310 patients (mean age 64 years; 51% female), the majority of whom had breast (19%), lung (25%), or other cancers (26%). For the cohort, severity of symptoms based on ESAS was low, but prevalence of specific symptoms was high including tiredness (84%), anxiety (60%), pain (60%), and low well-being (80%). Seventy percent of the cohort reported at least one supportive care need. The highest-ranking problems were fears and worries and needing information about illness/treatment. There were differences across tumor types with respect to symptoms and supportive care needs. Comorbidity and having a high number of supportive care needs were associated with higher symptom severity. Discussion Our results underscore the need to develop and implement tumor-specific supportive care interventions.