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.
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).
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.
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.
Use of patient-reported TRSC improves symptom documentation/management and patient HRQOL.
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.
Author Affiliations: School of Nursing, University of Kansas, Kansas City (Dr P. D. Williams); Mayo Clinic Health System–Franciscan Healthcare, La Crosse, Wisconsin (Mss Graham, Storlie, Pedace, and Otte); Mayo Clinic, Rochester, Minnesota (Mr Haeflinger and Dr Sloan); Children’s Mercy Hospitals & Clinics, Kansas City, Missouri (Mr Williams); Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa (Dr A.R. Williams).
The Franciscan Skemp Foundation provided funding for the study; consultations were provided by Thomas Grau, MD; health clinicians in the study were Paula Gill, MD; Dale Groshek, PA-C; Kiernan Minehan, MD; James Novotny, MD, FACP; and Haleem Rasool, MD, FACP. Velda J. Gonzalez, MSN, RN, PhD student, School of Nursing, University of Kansas, literature review; Carolyn D. Spears, administrative support, Children’s Mercy Hospitals and Clinics; Donna Dye, administrative support, Department of Health Policy and Management, College of Public Health, University of South Florida.
The authors have no conflicts of interest to disclose.
Author contributions: Dr P. D. Williams: ’conception and design, data acquisition, data analysis and interpretation, and manuscript write-up. Ms Graham: conception and design; data acquisition, and manuscript write-up. Ms Storlie, nurse coordinator: data acquisition and manuscript write-up. Ms Pedace: conception and design, data acquisition, and manuscript write-up. Mr Haeflinger: data acquisition, analysis and interpretation, and manuscript write-up. Mr Williams: data analysis and interpretation and manuscript write-up. Ms Otte: conception, data acquisition, and manuscript write-up. Dr Sloan: data analysis and write-up. Dr A. R. Williams: conception and design, data acquisition, data analysis and interpretation, and manuscript write-up.
Correspondence: Phoebe D. Williams, PhD, RN, FAAN, School of Nursing, University of Kansas, 3901 Rainbow Blvd, Mailstop 4043, Kansas City, KS 66106 ( email@example.com).
Accepted for publication April 4, 2012.