Predictors of high symptom burden in gynecologic oncology outpatients: Who should be referred to outpatient palliative care?

Lefkowits, Carolyn; Rabow, Michael W.; Sherman, Alexander E.; Kiet, T.; Ruskin, R.; Chan, John K.; Chen, Lee May

doi:10.1016/j.ygyno.2014.01.038

Cited by 45 publications

(37 citation statements)

References 25 publications

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“…The overall high symptom burden seen in our cohort is consistent with what has previously been described in gynecologic oncology cohorts in various stages of disease and treatments and various clinical settings [1][2][3][4][5]. Pain and fatigue are consistently among the most prevalent and bothersome symptoms.…”

Section: Discussionsupporting

confidence: 88%

“…The ESAS is a tool designed to evaluate symptoms in patients receiving palliative care [22]. It has been validated in cancer patients and has been used in prior studies of symptom burden in gynecologic oncology patients [2,5,[23][24][25]. Our scale is compressed from the original eleven point scale (0-10) to a four point scale (0-3) representing symptom intensity of none, mild, moderate or severe.…”

Section: Methodsmentioning

confidence: 99%

“…Women with gynecologic cancer experience a significant symptom burden throughout the disease course-from diagnosis through antineoplastic therapies and into both end-of-life care and survivorship [1][2][3][4][5]. Patients suffer both physical and psychological symptoms, including pain, nausea, fatigue, anorexia, neuropathy, sexual dysfunction, depression and anxiety.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Improvement in symptom burden within one day after palliative care consultation in a cohort of gynecologic oncology inpatients

Lefkowits

Teuteberg

Courtney‐Brooks

et al. 2015

Gynecologic Oncology

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Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improvement in symptom burden within one day after palliative care consultation in a cohort of gynecologic oncology inpatients

Lefkowits

Teuteberg

Courtney‐Brooks

et al. 2015

Gynecologic Oncology

Self Cite

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“…(24,25) Our results suggest that among OC survivors, age is less important than disease- and treatment-related factors such as symptoms in determining mobility. These findings are consistent with multiple studies that have identified an inverse relationship between age and cancer symptom severity,(26,27) and positive relationships between cancer symptom severity and general physical function,(28,29) suggesting that symptoms, rather than age, are the primary driver of mobility disability in OC.…”

Section: Discussionsupporting

confidence: 91%

Cancer and treatment-related symptoms are associated with mobility disability in women with ovarian cancer: A cross-sectional study

Campbell

Hagan

Gilbertson‐White

et al. 2016

Gynecologic Oncology

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Objective To examine the prevalence of symptom-related mobility disability and identify specific symptoms and other factors associated with mobility disability among a national sample of ovarian cancer (OC) survivors. Methods Descriptive, correlational secondary analysis of a National Ovarian Cancer Coalition mailed survey of women with a history of OC (N = 713). We used the Symptom Representation Questionnaire (SRQ), the MD Anderson Symptom Inventory (MDASI) Interference Scale, and medical and demographic information to determine prevalence of symptom-related mobility disability. We constructed a multiple linear regression model to determine the relative contributions of specific symptoms and other factors to mobility disability. Results A majority of the sample (60.0%) reported symptom-related mobility disability. Independent predictors included: > one comorbidity (β = 0.112, p = 0.001), active OC (β = 0.111, p = 0.037), abdominal bloating (β = 0.097, p = 0.006), fatigue (β = 0.314, p < 0.001), lack of appetite (β = 0.072, p = 0.045), numbness/tingling (β = 0.134, p < 0.001), and pain (β = 0.194, p < 0.001). The model explained 41.5% of the variance in symptom-related mobility disability (R2 = 0.415). Unexpectedly, age (β = -0.028, p = .412) and current chemotherapy (β = 0.107, p = 0.118) were not significant predictors. Conclusions Symptom-related mobility disability is common among women with OC and is associated with medical comorbidities, abdominal bloating, fatigue, lack of appetite, numbness/tingling, and pain. Longitudinal research should clarify the relationship of these symptoms to mobility disability and determine whether effective symptom management minimizes disability.

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“…(17) Within other branches of oncology, ESAS has been used by medical oncologists,(59, 60) radiation oncologists,(61) surgical oncologists,(62, 63) and gynecological oncologists. (64, 65) Outside of oncology, ESAS has also been adopted for symptom assessment in patients with kidney diseases,(66, 67) heart failure,(68, 69) pulmonary disorders,(70) hepatic diseases,(71) and sickle cell anemia. (72)…”

Section: Present Applicationsmentioning

confidence: 99%

The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments

Hui

Bruera

2017

Journal of Pain and Symptom Management

531

428

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Context Routine symptom assessment represents the cornerstone of symptom management. ESAS is one of the first quantitative symptom assessment batteries that allows for simple and rapid documentation of multiple patient-reported symptoms at the same time. Objective To discuss the historical development of ESAS, its current uses in different settings, and future developments. Methods Narrative review Results Since its development in 1991, ESAS has been psychometrically validated and translated into over 20 languages. We will discuss the variations, advantages and limitations with ESAS. From the clinical perspective, ESAS is now commonly used for symptom screening and longitudinal monitoring in patients seen by palliative care, oncology, nephrology, and other disciplines in both inpatient and outpatient settings. From the research perspective, ESAS has offered important insights into the nature of symptom trajectory, symptom clusters and symptom modulators. Furthermore, multiple clinical studies have incorporated ESAS as a study outcome and documented the impact of various interventions on symptom burden. On the horizon, multiple groups are actively investigating further refinements to ESAS, such as incorporating it in electronic health records, employing ESAS as a trigger for palliative care referral, and coupling ESAS with personalized symptom goals to optimize symptom response assessment. Conclusion ESAS has evolved over the past 25 years to become an important symptom assessment instrument in both clinical practice and research. Future efforts are needed to standardize this tool and explore its full potential to support symptom management.

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Predictors of high symptom burden in gynecologic oncology outpatients: Who should be referred to outpatient palliative care?

Cited by 45 publications

References 25 publications

Improvement in symptom burden within one day after palliative care consultation in a cohort of gynecologic oncology inpatients

Improvement in symptom burden within one day after palliative care consultation in a cohort of gynecologic oncology inpatients

Cancer and treatment-related symptoms are associated with mobility disability in women with ovarian cancer: A cross-sectional study

The Edmonton Symptom Assessment System 25 Years Later: Past, Present, and Future Developments

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