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Routine Surveillance of Chemotherapy Toxicities in Cancer Patients Using the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

Authors
  • Wang, Tian Qi1
  • Samuel, Joseph N.1
  • Brown, M. Catherine1
  • Vennettilli, Ashlee1
  • Solomon, Hannah1
  • Eng, Lawson1
  • Liang, Mindy1
  • Gill, Gursharan1
  • Merali, Zahra1
  • Tian, Chenchen1
  • Cheng, Nicholas Y. H.1
  • Campbell, Matthew2
  • Patel, Devalben1
  • Liu, Ai Xin1
  • Liu, Geoffrey1
  • Howell, Doris1
  • 1 Princess Margaret Cancer Center, Toronto, ON, Canada , Toronto (Canada)
  • 2 Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel , Tel Aviv (Israel)
Type
Published Article
Journal
Oncology and Therapy
Publisher
Springer Healthcare
Publication Date
Oct 22, 2018
Volume
6
Issue
2
Pages
189–201
Identifiers
DOI: 10.1007/s40487-018-0065-7
Source
Springer Nature
Keywords
License
Yellow

Abstract

IntroductionSystematic documentation of chemotoxicities in outpatient clinics is challenging. Incorporating patient-reported outcome (PRO) measures in clinical workflows can be an efficient strategy to strengthen the assessment of symptomatic treatment toxicities in oncology clinical practice. We compared the adequateness, feasibility, and acceptability of toxicity documentation using systematic, prospective, application of the PRO Common Toxicity Criteria for Adverse Events (PRO-CTCAE) tool.MethodsAt a comprehensive cancer center, data abstraction of electronic health record reviews elucidated current methods and degree of chemotoxicity documentation. Web-based 32-item PRO-CTCAE questionnaires, administered in ambulatory clinics of patients receiving chemotherapy, captured chemotoxicities and respective severities. Patient telephone surveys assessed whether healthcare providers had addressed chemotoxicities to the patients’ satisfaction.ResultsOver a broad demographic of 497 patients receiving chemotherapy, 90% (95% CI 84–96%) with significant chemotoxicities (n = 107) reported that their providers had discussed toxicities with them; of these, 70% received a therapy management change, while among the rest, 17% desired a change in management. Of patients surveyed, 91% (95% CI 82–99%) were satisfied with their current chemotoxicity management. Clinician chart documentation varied greatly; descriptors rather than numerical grading scales were typically used. Although 93% of patients were willing to complete the PRO survey, only 50% thought that it would be acceptable to complete this survey at routine clinic visits.ConclusionUse of PRO-CTCAE in routine clinical practice promotes systematic evaluation of symptomatic toxicities and improves the clarity, consistency, and efficiency of clinician documentation; however, methods to improve patient willingness to complete this tool routinely are needed.

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