The detection and treatment of cancer-related functional problems in an outpatient setting

Goals of work Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional prob...

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Bibliographic Details
Published in:Supportive care in cancer 2009-01, Vol.17 (1), p.61-67
Main Authors: Cheville, A. L., Beck, L. A., Petersen, T. L., Marks, R. S., Gamble, G. L.
Format: Article
Language:English
Subjects:
Activities of daily living
Adult
Aged
Aged, 80 and over
Ambulatory Care - standards
Cancer
Documentation
Female
Humans
Male
Medical records
Medical Records Systems, Computerized - standards
Medicine
Medicine & Public Health
Middle Aged
Minnesota
Nausea
Neoplasms - complications
Neoplasms - physiopathology
Neoplasms - rehabilitation
Nursing
Nursing Research
Oncology
Original Article
Pain Medicine
Patients
Practice Patterns, Physicians' - standards
Questionnaires
Referral and Consultation
Rehabilitation
Rehabilitation Medicine
Retrospective Studies
Surveys and Questionnaires
Young Adult
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Summary:Goals of work Cancer causes functional problems that are often neither detected nor treated in the outpatient setting. Patient–physician communication regarding functional issues may contribute. This study was conducted to quantify the degree of concordance between patient-identified functional problems and their documentation in the oncology-generated medical record. Materials and methods We administered a 27-item questionnaire addressing cancer-related symptoms, signs, and functional problems to a consecutive sample of 244 patients undergoing outpatient cancer treatment. Oncology clinician-generated notation in the electronic medical record (EMR) was systematically reviewed for documentation of the instrument items. EMR review began the day of instrument completion and extended retrospectively for 6 months. Main results Eighty-three percent (202) completed the survey with at least one cancer-related symptom, sign, or functional problem identified by 71.8%, 33.2% and 65.8% of patients, respectively. Difficulty with ambulation (23.9%) and balance (19.4%) were the most frequent functional problems. Clinician notes referred to 49% of patients’ symptoms, but only 37% of their signs and 6% of their functional problems. Pain, weight loss, and nausea (ORs > 4.9, p  
ISSN:0941-4355
1433-7339
DOI:10.1007/s00520-008-0461-x