Evaluation and Pharmacologic Management of Symptoms in Cancer Patients Undergoing Acute Rehabilitation in a Comprehensive Cancer Center

• Published in: Archives of physical medicine and rehabilitation Vol. 88; no. 7; pp. 891 - 895
• Main Authors: Guo, Ying, MD, Young, Beth L., APN, Hainley, Susan, APN, Palmer, J. Lynn, PhD, Bruera, Eduardo, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2007; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Analgesics - therapeutic use; Antidepressive Agents - therapeutic use; Anxiety - drug therapy; Appetite - physiology; Appetite Stimulants - therapeutic use; Biological and medical sciences; Cancer; Cancer Care Facilities; Cathartics - therapeutic use; Constipation - drug therapy; Constipation - physiopathology; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Drug Prescriptions - statistics & numerical data; Fatigue - drug therapy; Fatigue - physiopathology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Hypnotics and Sedatives - therapeutic use; Length of stay; Length of Stay - statistics & numerical data; Male; Medical sciences; Middle Aged; Miscellaneous; Neoplasms - physiopathology; Neoplasms - psychology; Neoplasms - therapy; Nervous system (semeiology, syndromes); Neurology; Other diseases. Semiology; Pain - drug therapy; Pain - physiopathology; Pain Measurement; Patient Discharge; Physical Medicine and Rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Retrospective Studies; Signs and symptoms; Sleep Initiation and Maintenance Disorders - drug therapy; Sleep Initiation and Maintenance Disorders - physiopathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Texas; Texas; Signs and symptoms; Rehabilitation; Cancer; Length of stay; Prognosis; Improvement; Reeducation; Rehabilitation center; Intestinal disease; Female; Anxiety; Hospital; Neurological disorder; Woman; Constipation; Age; Mood disorder; Human; Nervous system diseases; Residence time; Acute; Sleep disorder; Fatigue; Malignant tumor; Discharge; Quality of life; Symptomatology; Treatment; Follow up study; Insomnia; Rehabilitation(human); Digestive diseases
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2007.03.032

Abstract Guo Y, Young BL, Hainley S, Palmer JL, Bruera E. Evaluation and pharmacologic management of symptoms in cancer patients undergoing acute rehabilitation in a comprehensive cancer center. Objectives To identify cancer patients’ symptoms at admission and on discharge from an acute rehabilitation unit, to document the discharge medications used for symptom management, and to assess how symptoms affect lengths of stay (LOS). Design Retrospective chart review. Setting Acute inpatient rehabilitation unit within a tertiary cancer center. Participants Ninety-six patients (49 men, 47 women) were admitted to an acute inpatient rehabilitation unit. The median age was 64 years (range, 26–87y). Interventions Not applicable. Main Outcome Measure Edmonton Symptom Assessment Scale (ESAS) scores at admission and on discharge. Results The most intense symptom (mean ESAS visual analog scale score ± standard deviation) on admission was poor appetite (3.7±3.3), followed by fatigue (3.4±2.6). Similar results were found for the 63 patients with ESAS scores available at both time points. On discharge, poor appetite (2.2±2.4) was still the most intense symptom reported, again followed by fatigue (2.2±2.1). There were significant improvements in anxiety ( P =.001), constipation ( P =.001), fatigue ( P =.002), pain ( P =.003), appetite ( P =.004), sense of well-being ( P =.01), and insomnia ( P =.04). Seventy percent (65/93) of patients received discharge prescriptions for symptom control, with analgesics being the most frequently prescribed. The poor appetite and depression admission scores correlated positively with hospital LOS ( P <.001, P =.05, respectively). Conclusions Assessment of symptoms revealed significant symptom burdens in cancer patients undergoing rehabilitation. Pharmacologic interventions for management of symptoms were frequently needed.