• The oncologist · Feb 2019

    Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients.

    • Sebastiano Mercadante, Claudio Adile, Gaetano Lanzetta, Kyriaki Mystakidou, Marco Maltoni, Guilherme Soares Luiz L Post-Acute Care Services and Palliative Care Program, Hospital Placi, Niterói, Rio de Janeiro, Brazil., Stefano De Santis, Patrizia Ferrera, Marco Valenti, Marta Rosati, Romina Rossi, Andrea Cortegiani, Francesco Masedu, Franco Marinangeli, and Federica Aielli.
    • Pain Relief & Supportive Care, La Maddalena Cancer Center, Palermo, Italy terapiadeldolore@lamaddalenanet.it 03sebelle@gmail.com.
    • Oncologist. 2019 Feb 1; 24 (2): 239-246.

    BackgroundThe aim of this study was to assess the patients' global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors.Subjects, Materials, And MethodsAdvanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated.ResultsEight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71-2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio.ConclusionPSG and PGI seem to be relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response.Implications For PracticePersonalized symptom goals and global impression of change are relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response.© AlphaMed Press 2018.

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