Daily patient-reported assessment of pain, anxiety, or distress, problems or concerns, and need to see physician during 100 courses of radiation therapy

• Published in: Journal of clinical oncology Vol. 32; no. 31_suppl; p. 193
• Main Authors: Howell, David D., Wilson, Colette M., Moore, William Andrew
• Format: Journal Article
• Language: English
• Published: 01.11.2014
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/jco.2014.32.31_suppl.193

Abstract only 193 Background: Patients (pts) undergoing radiation therapy (RT) treatment (Rx) may have pain, anxiety or distress (AoD), or other problems at the time of initiation of RT. Pts may also develop or have an exacerbation of one or more problems during RT. While undergoing RT, pts are seen weekly by the treating physician (MD), and seen daily by the treating radiation therapy technologists (RTT). Pts can develop problems between weekly MD visits which may benefit from expedited interventions. A protocol was developed where pts would be asked four questions each treatment day by the RTT: 1) Are you having pain, and if so, how would you rate it on a scale of zero to 10? (PainQ) 2) Are you having anxiety or distress today? (ADQ) 3) Are you having new problems or concerns? (ProConQ) 4) Do you want to see the physician today? (CMDQ) This information was charted, and used in pt management. Methods: 100 consecutive pt charts were reviewed for demographics including gender, age, primary malignancy, region treated, number of Rx and radiation dose. Daily answers from the four question instrument were also reviewed for each pt course of RT. Results: Of the 100 pt, 56 were male. Disease distribution: Breast-22; Prostate-20; Head and Neck-20; Lung-13; Brain-7; Other-18. For the ADQ, 83 did not report anxiety or distress; 17 reported AoD on 1-2 occasions. For the ProConQ, 35 reported none, 34 reported yes on 1-2 occasions, 22 reported yes on 3-5 occasions, and 9 reported yes on >5 occasions. 29 reported yes on 2 days in a row, and 15 reported yes on 3 days in a row. For the PainQ, 31 reported no pain throughout their course of RT, with 22, 23, and 25 reporting pain of any magnitude for 1 to 5, 6 to10, and >10 days, respectively. 22 reported pain level > 6 on at least one occasion. For CMDQ, 26 pts did not request to see the MD greater than the usual weekly visit, 71 and 3 requested to see the MD an additional 1 to 5, and 6 to 10 times. Conclusions: A simple four question daily query of pts undergoing a course of RT is feasible, and may prompt the need for evaluation and interventions between scheduled MD visits. This may facilitate more expeditious interventions for Rx related toxicity and treatment-dependent or independent symptoms or needs.