Phase II Trial of Symptom Screening With Targeted Early Palliative Care for Patients With Advanced Cancer
| Autor: | Camilla Zimmermann, Rebecca M. Prince, Brittany Chow, Monika K. Krzyzanowska, Doris Howell, Christopher M. Booth, Ashley Pope, Deborah Dudgeon, Natasha B. Leighl, Amit M. Oza, Philippe L. Bedard, Madeline Li, Stephanie Lheureux, Neesha C. Dhani, Leonie Herx, Aaron R. Hansen, Srikala S. Sridhar, Anne Rydall, Breffni Hannon, Gary Rodin, Geoffrey Liu, Jennifer J. Knox, Nadia Swami, Lisa W. Le, Jean Mathews |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Palliative care business.industry Palliative Care MEDLINE Advanced cancer Mood Oncology Quality of life Neoplasms Internal medicine Ambulatory Quality of Life Humans Medicine Symptom control Patient Reported Outcome Measures business Early Detection of Cancer Depression (differential diagnoses) |
| Zdroj: | Journal of the National Comprehensive Cancer Network. 20:361-370.e5 |
| ISSN: | 1540-1413 1540-1405 |
| DOI: | 10.6004/jnccn.2020.7803 |
| Popis: | Background: Routine early palliative care (EPC) improves quality of life (QoL) for patients with advanced cancer, but it may not be necessary for all patients. We assessed the feasibility of Symptom screening with Targeted Early Palliative care (STEP) in a phase II trial. Methods: Patients with advanced cancer were recruited from medical oncology clinics. Symptoms were screened at each visit using the Edmonton Symptom Assessment System-revised (ESAS-r); moderate to severe scores (screen-positive) triggered an email to a palliative care nurse, who called the patient and offered EPC. Patient-reported outcomes of QoL, depression, symptom control, and satisfaction with care were measured at baseline and at 2, 4, and 6 months. The primary aim was to determine feasibility, according to predefined criteria. Secondary aims were to assess whether STEP identified patients with worse patient-reported outcomes and whether screen-positive patients who accepted and received EPC had better outcomes over time than those who did not receive EPC. Results: In total, 116 patients were enrolled, of which 89 (77%) completed screening for ≥70% of visits. Of the 70 screen-positive patients, 39 (56%) received EPC during the 6-month study and 4 (6%) received EPC after the study end. Measure completion was 76% at 2 months, 68% at 4 months, and 63% at 6 months. Among screen-negative patients, QoL, depression, and symptom control were substantially better than for screen-positive patients at baseline (all PPConclusions: STEP is feasible in ambulatory patients with advanced cancer and distinguishes between patients who remain stable without EPC and those who benefit from targeted EPC. Acceptance of the triggered EPC visit should be encouraged. ClinicalTrials.gov identifier: NCT04044040. |
| Databáze: | OpenAIRE |
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