Feasibility and acceptability of implementing an electronic patient reported outcome (e-PRO) dysphagia screening tool for routine multidisciplinary care.

Authors

null

Kishan Shani

University of Toronto, Toronto, ON, Canada

Kishan Shani , Michael Borean , Judy Chen , Yuchen Li , M. Catherine Brown , Ashlee Vennettilli , Anthea Lau , Dennis Zheng , Qin Kuang , Kevin Boyd , Yvonne Leung , David Cella , Helen Mackay , Gail Elizabeth Darling , Rebecca Wong , Deval Patel , Wei Xu , Geoffrey Liu , Doris Howell

Organizations

University of Toronto, Toronto, ON, Canada, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada, Princess Margaret Cancer Centre, Toronto, ON, Canada, Ontario Cancer Institute, Princess Margaret Cancer Centre, Toronto, ON, Canada, Princess Margaret Cancer Center, Toronto, ON, Canada, Northwestern University, Feinberg School of Medicine, Chicago, IL, Toronto General Hospital, Toronto, ON, Canada, Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada, Biostatistics, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada

Research Funding

Other

Background: In Ontario, Canada, longitudinal patient self-reporting of 9 common cancer symptoms and a global health scale (Edmonton Symptom Assessment System, ESAS) is mandated and used clinically as a screening tool for multidisciplinary precision care (chemo/rads/surg). However, a common GI symptom, dysphagia, is not assessed in the same setting. Methods: Mostly gastro-esophageal cancer outpatients (some head and neck and lung cancer patients undergoing radiation were also included for generalizability) received one of two versions (V1, V2) of the dysphagia screening tool based on PRO-CTCAE-derived language. The tool included two screening questions, which when answered affirmatively, led to more comprehensive dysphagia/odynophagia questioning. The survey was introduced on iPads with V1. An assessment of acceptability through patient survey was additionally included in V2, and the duration of survey completion was recorded. Exploratory in-depth interviews were conducted with oncologists to assess usability in the clinic setting. Results: Of 101 approached and eligible, 79 consented, and 66 completed the survey. Median completion time was 2.12 ± 0.80 min. 95% were happy to complete survey on a touchscreen tablet, 88% did not find completion of survey time-consuming, and 91% found completion of survey useful in order to tell the clinician how they feel physically and emotionally. The prevalence of dysphagia based on screening question #1 (“difficulty upon swallowing?”) was 38% (25/66), while for screening question #2 (“pain upon swallowing?”) prevalence was 18% (12/66). Five interviewed physicians found the survey to be clinically informative, not burdensome in terms of time consumption, and felt it would be a valuable addition to outpatient clinics. One recurring suggestion was to combine the two screening questions into one. Results were similar across GI, head and neck, and lung cancer sites. Conclusions: The e-PRO dysphagia screening tool is acceptable and feasible for patients, and useful for clinicians. Next, a modified one-question dysphagia tool will be assessed in the multidisciplinary care of gastro-esophageal cancer patients.

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Abstract Details

Meeting

2017 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach

Track

Cancers of the Esophagus and Stomach

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 35, 2017 (suppl 4S; abstract 155)

DOI

10.1200/JCO.2017.35.4_suppl.155

Abstract #

155

Poster Bd #

L3

Abstract Disclosures

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