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Prospective Study of Use of Edmonton Symptom Assessment Scale Versus Routine Symptom Management During Weekly
Uma D Goyal1, Kristen Riegert2, Rajayogesh Davuluri3
1Department of Radiation Oncology, University of Arizona, Tucson, AZ.
JCO Oncology Practice
|May 9, 2020
Summary
Integrating the Edmonton Symptom Assessment Scale (ESAS) into weekly physician visits improved symptom management for cancer patients undergoing radiotherapy. This validated tool enhances patient care by enabling timely interventions for pain, nausea, and anxiety.
Area of Science:
- Oncology
- Palliative Care
- Quality Improvement
Background:
- Radiotherapy (RT) patients experience symptoms managed during weekly physician on-treatment visits (OTVs).
- The Edmonton Symptom Assessment Scale (ESAS) is a validated tool for patients with cancer to report symptoms.
- Effective symptom management is crucial for improving patient quality of life during cancer treatment.
Purpose of the Study:
- To investigate if physician review of ESAS during weekly OTVs improves symptom severity in cancer patients undergoing RT.
- To assess the impact of integrating a validated symptom assessment tool into routine clinical practice.
- To determine if proactive symptom management leads to better patient outcomes.
Main Methods:
- A quality improvement project comparing two groups of patients undergoing RT.
- Preintervention group: 85 patients completed weekly ESAS, blinded to providers.
- Postintervention group: 170 patients completed weekly ESAS, reviewed by providers for potential intervention.
- Multivariate logistic regression analyzed the association between the intervention and symptom severity.
Main Results:
- The postintervention group showed significantly improved or stable symptom severity for pain (85.6% vs 70.7%) and anxiety (92.9% vs 79.3%).
- Multivariate analysis indicated a decreased association with worsening symptoms for pain, nausea, loss of appetite, and anxiety in the postintervention group.
- Healthcare providers found the ESAS review useful, with 87.5% of physicians and 75% of nurses reporting utility.
Conclusions:
- Incorporating ESAS into OTVs is associated with stable or improved symptom severity, particularly when therapeutic interventions are readily available.
- Validated patient-reported outcome tools like ESAS can enhance physician management of cancer-related symptoms.
- This approach facilitates timely and targeted interventions, potentially improving the overall treatment experience for patients undergoing radiotherapy.
