Patient-Reported Outcomes for Assessing Symptom Burden in Patients Receiving Oral Anticancer Therapy

Key Points

  • Patient-reported outcomes can be used in the clinical setting to alert physicians to symptom burden.
  • Overall, 55.5% of assessments contained at least 1 symptom that should have prompted clinician intervention.

In a study reported in the Journal of Oncology Practice, Mackler et al found that use of a validated symptom assessment tool for patient-reported outcomes was feasible in evaluating symptom burden in outpatients receiving oral anticancer treatment in the clinical setting.

Study Details

The study involved use of a modified Edmonton Symptom Assessment Scale-revised (ESAS-r) survey by patients receiving oral anticancer treatment (excluding endocrine treatments) at eight oncology practices in Michigan as part of a Michigan Oncology Quality Consortium initiative. Patients reported symptom burden for 13 symptoms on the survey before each outpatient visit as mild (0–3), moderate (4–6), or severe (7–10). Oral anticancer treatments used by patients included capecitabine, lenalidomide (Revlimid), erlotinib (Tarceva), enzalutamide (Xtandi), regorafenib (Stivarga), and nilotinib (Tasigna).

Patient-Reported Symptoms and Severity

A total of 1,235 surveys were collected. Overall, 82.5% of symptoms were categorized as mild; 11.9%, as moderate; and 5.6%, as severe. On the basis of predefined thresholds of the modified ESAS-r in alerting health-care providers when patients report symptoms as moderate or severe, 55.5% of assessments contained at least one symptom that should have prompted clinician intervention. Patients reported moderate or severe symptoms most frequently in the domains of overall well-being (34%), fatigue (35%), and pain (20%). In 23% of the assessments, 4 or more symptoms were rated as moderate to severe.

The investigators concluded: [Patient-reported outcomes] can be evaluated through the use of a standardized tool, such as the ESAS-r, in oncology patients receiving oral oncolytic therapy. Implementing such a tool in both community and academic practices is feasible and may facilitate improvements in the quality of care.”

Emily Mackler, PharmD, BCOP, of the University of Michigan School of Public Health, is the corresponding author of the Journal of Oncology Practice article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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