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Keywords

Cancer treatments, Evidence-based practice, Healthcare delivery, HRQOL, Symptom management, TRSC

 

Authors

  1. Williams, Phoebe D. PhD, RN, FAAN
  2. Graham, Kathleen M. MS, BSN, RN, APNP-BC, AOCN, CNS
  3. Storlie, Deborah L. RN, NC
  4. Pedace, Therese M. BSN, RN
  5. Haeflinger, Kurt V. BS
  6. Williams, David D. MPH
  7. Otte, Diane MS, RN, OCN
  8. Sloan, Jeff A. PhD
  9. Williams, Arthur R. PhD, MA, MPA

Abstract

Background: Cancer treatment efficacy has improved with therapies at high or sustained dosages. However, there is increasing concern about symptom management and patients' quality of life.

 

Objective: The objective of this study was to assess whether use of a Therapy-Related Symptom Checklist (TRSC) with oncology outpatients increases the number of symptoms documented and managed and whether this improves patients' health-related quality of life (HRQOL).

 

Methods: This was a sequential cohort trial. Fifty-five oncology outpatients in treatment received standard of care (group 1, G1). Afterward, another 58 patients (group 2, G2) received standard of care at the same clinic; however, these patients additionally answered the TRSC immediately prior to each consultation. The TRSC results were then shared with clinicians. Repeated measures (2-11 visits) were obtained of the number of patient treatment symptoms documented (medical records G1 and TRSC G2), HRQOL, and Karnofsky scores, n = 696 observations (328 G1 and 368 G2). The number of symptoms reported and HRQOL were covariate adjusted using population averaged generalized estimating equations.

 

Results: G2 patients had a 7.2% higher population averaged covariate-adjusted HRQOL than G1 patients (3.3 more points on HRQOL, P = .012). One hundred sixteen percent more covariate- and non-covariate-adjusted symptoms were documented/managed in G2 than G1 (6.14 symptoms vs 2.84, P < .0001). The HRQOL, TRSC, and Karnofsky scores correlated r > 0.40.

 

Conclusion: Use of patient-reported TRSC improves symptom documentation/management and patient HRQOL.

 

Implications for Practice: Study findings were consistent with recent research that has shown that use of checklists can have powerful influences on both quality and safety of healthcare services and patient outcomes.