Patel M

Background: Undertreated symptoms are common among patients with lung cancer and lead to increased use of acute care facilities. Studies show that better symptom management can improve patient quality of life. It is unknown, however, whether provider knowledge and documentation of patients’ symptoms results in improved symptom management. Therefore, we conducted a randomized study to evaluate whether patient-reported symptoms improved provider documentation and symptom management among Veterans diagnosed with lung cancer.

Methods: All Veterans with lung cancer receiving ongoing treatment with chemotherapy or immunotherapy were randomized to either usual care or usual care enhanced with a lay health worker-led weekly telephonic symptom assessment. Symptoms rated at a 4 or greater on a scale from 0 to 10 with 10 being the worst possible were documented in the patient’s chart and their provider notified. The patients’ charts were reviewed retrospectively to determine if symptoms were documented and managed at the patient’s next clinic visit.

Results: Between July 01, 2017 and May 01, 2018, 37 Veterans consented and were enrolled in the study. Retrospective chart review was performed for 30 participants (usual care n = 15, intervention n = 15). Across both groups, median age was 68 years, majority were non-Hispanic white (67%), male (99%), and diagnosed with stage IV disease. Provider documentation and management of symptoms did not improve in the intervention group when compared to the usual care group at baseline, 3 months, and 6 months (P = .41, P = .50, P = .51, respectively).

Conclusions: Patient-reported symptoms are important to ensuring timely interventions to decrease symptom burden. However, challenges remain in ensuring that symptoms that are reported result in a timely intervention by clinical providers. Weekly symptom assessment holds promise in reducing symptom severity but more research is needed to ensure that providers document and intervene on symptoms reported by patients.

Background: Undertreated symptoms are common among patients with lung cancer and lead to increased use of acute care facilities. Studies show that better symptom management can improve patient quality of life. It is unknown, however, whether provider knowledge and documentation of patients’ symptoms results in improved symptom management. Therefore, we conducted a randomized study to evaluate whether patient-reported symptoms improved provider documentation and symptom management among Veterans diagnosed with lung cancer.

Methods: All Veterans with lung cancer receiving ongoing treatment with chemotherapy or immunotherapy were randomized to either usual care or usual care enhanced with a lay health worker-led weekly telephonic symptom assessment. Symptoms rated at a 4 or greater on a scale from 0 to 10 with 10 being the worst possible were documented in the patient’s chart and their provider notified. The patients’ charts were reviewed retrospectively to determine if symptoms were documented and managed at the patient’s next clinic visit.

Results: Between July 01, 2017 and May 01, 2018, 37 Veterans consented and were enrolled in the study. Retrospective chart review was performed for 30 participants (usual care n = 15, intervention n = 15). Across both groups, median age was 68 years, majority were non-Hispanic white (67%), male (99%), and diagnosed with stage IV disease. Provider documentation and management of symptoms did not improve in the intervention group when compared to the usual care group at baseline, 3 months, and 6 months (P = .41, P = .50, P = .51, respectively).

Conclusions: Patient-reported symptoms are important to ensuring timely interventions to decrease symptom burden. However, challenges remain in ensuring that symptoms that are reported result in a timely intervention by clinical providers. Weekly symptom assessment holds promise in reducing symptom severity but more research is needed to ensure that providers document and intervene on symptoms reported by patients.

Background: Undertreated symptoms are common among patients with lung cancer and lead to increased use of acute care facilities. Studies show that better symptom management can improve patient quality of life. It is unknown, however, whether provider knowledge and documentation of patients’ symptoms results in improved symptom management. Therefore, we conducted a randomized study to evaluate whether patient-reported symptoms improved provider documentation and symptom management among Veterans diagnosed with lung cancer.

Methods: All Veterans with lung cancer receiving ongoing treatment with chemotherapy or immunotherapy were randomized to either usual care or usual care enhanced with a lay health worker-led weekly telephonic symptom assessment. Symptoms rated at a 4 or greater on a scale from 0 to 10 with 10 being the worst possible were documented in the patient’s chart and their provider notified. The patients’ charts were reviewed retrospectively to determine if symptoms were documented and managed at the patient’s next clinic visit.

Results: Between July 01, 2017 and May 01, 2018, 37 Veterans consented and were enrolled in the study. Retrospective chart review was performed for 30 participants (usual care n = 15, intervention n = 15). Across both groups, median age was 68 years, majority were non-Hispanic white (67%), male (99%), and diagnosed with stage IV disease. Provider documentation and management of symptoms did not improve in the intervention group when compared to the usual care group at baseline, 3 months, and 6 months (P = .41, P = .50, P = .51, respectively).

Conclusions: Patient-reported symptoms are important to ensuring timely interventions to decrease symptom burden. However, challenges remain in ensuring that symptoms that are reported result in a timely intervention by clinical providers. Weekly symptom assessment holds promise in reducing symptom severity but more research is needed to ensure that providers document and intervene on symptoms reported by patients.