Chair, Accreditation Decision Committee
Routine Screening for Suicidal Intention in Patients with Cancer
“Suicidal ideation is reported on an electronic distress screening tool (DART) by almost 6% of cancer patients, of whom almost 11% report suicidal intention and 33% decline to indicate intention. DART demonstrated utility in identifying patients who may be at highest risk of completed suicide and who require urgent clinical assessment.”
Leung, Y. W., Li, M., Devins, G., Zimmermann, C., Rydall, A., Lo, C. and Rodin, G. (2013), Routine screening for suicidal intention in patients with cancer. Psycho-Oncology, 22: 2537–2545. doi: 10.1002/pon.3319
The Utility of the Edmonton Symptom Assessment System in Screening for Anxiety and Depression
“The Edmonton Symptom Assessment System (ESAS) is a common screening tool in cancer, although its validity for distress screening is unproven. Here, screening performance of the ESAS anxiety (ESAS-A) and depression (ESAS-D) items were validated against the anxiety [Generalised Anxiety Disorder-7 (GAD-7)] and depression [Patient Health Questionnaire-9 (PHQ-9)] subscales of the PHQ. A total of 1215 cancer patients completed the Distress Assessment and Response Tool (DART), a computerised distress screening instrument. High sensitivities of ESAS-A and ESAS-D at certain cut-offs suggest they have use in ruling-out distress.”
BAGHA, S.M., MACEDO, A., JACKS, L.M., LO, C., ZIMMERMANN, C., RODIN, G. and LI, M. (2013), The utility of the Edmonton Symptom Assessment System in screening for anxiety and depression. European Journal of Cancer Care, 22: 60–69. doi: 10.1111/j.1365-2354.2012.01369.x
Qualitative Analysis of Practicing Oncologists’ Attitudes and Experiences Regarding Collection of Patient-Reported Outcomes
“There is growing interest in incorporating routine collection of patient-reported outcomes (PROs) into cancer care. Practicing oncologists are a stakeholder group whose views are not well characterized. Seventeen interviews were conducted with oncologists from 15 states. Emergent themes included variable understanding and experience with PROs. There was enthusiasm for the potential of PROs to improve the efficiency and thoroughness of the patient encounter. Fundamental concerns included information overload, possibility of identifying problems without access to intervention, depersonalization of the physician-patient encounter, cost, and inefficiency. Barriers identified included the need for buy-in from other stakeholders in the practice, lack of appropriate referral resources, staffing needs, and technology concerns. Few identified patient compliance, data sharing/privacy, or medical liability as a major barrier to implementation.”
Reshma J., Anne C., Blase N.P., Bruno C.M., Kristen M., Amy P.A., Robin Z., and Patrick J.L. (2013), Qualitative Analysis of Practicing Oncologists’ Attitudes and Experiences Regarding Collection of Patient-Reported Outcomes. Journal of Practice, November 2013 vol. 9 no. 6, e290-e297.
Exploring the Experience
“There has been a 30% increase in patient volumes at PMH in the past 5 years; more patients are living longer and requiring well follow up. Their needs, concerns and goals are evolving and chronic disease management models are being advocated in response. The demand for increased services may outweigh the resources available unless novel, proactive, collaborative care approaches are developed. We are called to respond, to be patientcentered, preventative and targeted in our approach to balancing patient needs and staff workloads.”
Li M., Macedo A., D’Angelo S., Brown J. (2010), Exploring the Experience. Psychosocial Oncology, Summer 2010 vol. 2 Issue 2.