Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients

The oncologist

article

Sebastiano Mercadante¹  Marta Rosati²  Romina Rossi²  Andrea Cortegiani³  Francesco Masedu⁴  Franco Marinangeli⁵  Federica Aielli⁴  Claudio Adile¹  Gaetano Lanzetta⁶  Kyriaki Mystakidou⁸  Marco Maltoni²  Luiz Guilherme Soares⁹  Stefano De Santis^1,10  Patrizia Ferrera¹  Marco Valenti⁴ 

[1] La Maddalena Cancer Center;Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS;Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anesthesia, Intensive Care and Emergency, University of Palermo;Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine;Anesthesiology and Pain Medicine, Department of Life Health and Environmental Sciences, University of L'Aquila;Medical Oncology Unit;Medical Oncology Unit, Italian Neuro-Traumatology Institute;Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, National & Kapodistrian University of Athens, School of Medicine;Post-Acute Care Services and Palliative Care Program, Hospital Placi;S. Camillo-Forlanini Hospital

关键词: Advanced cancer;    Symptom assessment;    Palliative care;    Personalized symptom goal;    Global impression of change;   

DOI  :  10.1634/theoncologist.2017-0668

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background The aim of this study was to assess the patients’ global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Results Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71–2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. Conclusion PSG and PGI seem to be relevant for patients’ assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Implications for Practice Personalized symptom goals and global impression of change are relevant for patients’ assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response.

【 授权许可】

CC BY|CC BY-NC