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Does routine symptom screening with ESAS decrease ED visits in breast cancer patients undergoing adjuvant

L Barbera1, R Sutradhar, D Howell

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Summary
This summary is machine-generated.

Screening women with breast cancer using the Edmonton Symptom Assessment Scale (ESAS) significantly reduced emergency department (ED) visits. This patient-reported outcome measure proved effective in a real-world setting, lowering ED visit rates by 43%.

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Area of Science:

  • Oncology
  • Health Services Research
  • Patient-Reported Outcomes

Background:

  • Ontario, Canada implemented a province-wide symptom screening program using the Edmonton Symptom Assessment Scale (ESAS) in 2007.
  • This study focuses on women diagnosed with breast cancer undergoing adjuvant chemotherapy.

Purpose of the Study:

  • To evaluate the impact of Edmonton Symptom Assessment Scale (ESAS) screening on emergency department (ED) visit rates.
  • To determine if routine symptom screening affects healthcare utilization in breast cancer patients.

Main Methods:

  • Retrospective cohort study utilizing linked administrative healthcare data from Ontario, Canada.
  • Included women aged 18+ diagnosed with stage I-III breast cancer (2007-2009) receiving adjuvant chemotherapy.
  • An adjusted recurrent event model analyzed the association between ESAS screening and ED visit rates.

Main Results:

  • Prior ESAS screening was associated with a 43% lower rate of ED visits compared to no prior screening.
  • Each additional ESAS assessment correlated with a 17% decrease in the ED visit rate.
  • The relative rate of ED visits was 0.57 when prior ESAS screening occurred.

Conclusions:

  • Routine screening with the Edmonton Symptom Assessment Scale (ESAS) is linked to reduced emergency department visits in breast cancer patients.
  • This study provides real-world evidence on the effectiveness of documenting patient-reported outcomes to decrease healthcare utilization.