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Fujihara T, Sano M, Negoro Y, Yamashita S, Kokubun H, Yano R. Fatigue in patients with cancer receiving outpatient chemotherapy: a prospective two-center study. J Pharm Health Care Sci 2023; 9:7. [PMID: 36803913 PMCID: PMC9936686 DOI: 10.1186/s40780-023-00275-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is one of the most common symptoms in patients with cancer. However, CRF has not been sufficiently evaluated as it involves various factors. In this study, we evaluated fatigue in patients with cancer receiving chemotherapy in an outpatient setting. METHODS Patients with cancer receiving chemotherapy at the outpatient treatment center of Fukui University Hospital and Saitama Medical University Medical Center Outpatient Chemotherapy Center were included. The survey period was from March 2020 to June 2020. The frequency of occurrence, time, degree, and related factors were examined. All patients were asked to fill out the Edmonton Symptom Assessment System Revised Japanese version (ESAS-r-J) questionnaire, which is a self-administered rating scale, and patients with ESAS-r-J "Tiredness" scores of ≥ 3 were evaluated for factors related to tiredness, such as age, sex, weight, and laboratory parameters. RESULTS A total of 608 patients were enrolled in this study. Fatigue after chemotherapy occurred in 71.0% of patients. ESAS-r-J "Tiredness" scores of ≥ 3 were observed in 20.4% of patients. The factors related to CRF were low hemoglobin level and high C-reactive protein level. CONCLUSIONS Twenty percent of patients receiving cancer chemotherapy on an outpatient basis had moderate or severe CRF. Patients with anemia and inflammation are at increased risk of developing fatigue after cancer chemotherapy.
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Affiliation(s)
- Takuya Fujihara
- grid.416093.9Department of Pharmacy Services, Saitama Medical Center, 1981 Kamoda, Kawagoe, Saitama 350-8550 Japan
| | - Motohiko Sano
- Department of Pharmacy Services, Saitama Medical Center, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan. .,Division of Applied Pharmaceutical Education and Research, Hoshi University, 2-4-41 Ebara, Shinagawa-Ku, Tokyo, 142-8501, Japan.
| | - Yutaka Negoro
- grid.413114.2Department of Pharmacy, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji, Fukui 910-1193 Japan
| | - Shinji Yamashita
- grid.413114.2Department of Pharmacy, University of Fukui Hospital, 23-3 Matsuoka Shimoaizuki, Eiheiji, Fukui 910-1193 Japan
| | - Hideya Kokubun
- grid.410785.f0000 0001 0659 6325Center for Experiential Pharmacy Practice, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, 192-0392 Japan
| | - Ryoichi Yano
- Education and Research Center for Clinical Pharmacy, Faculty of Pharmacy, Osaka Medical and Pharmaceutical University, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094 Japan
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Shamieh O, Alarjeh G, Qadire MA, Amin Z, AlHawamdeh A, Al-Omari M, Mohtadi O, Illeyyan A, Ayaad O, Al-Ajarmeh S, Al-Tabba A, Ammar K, Al-Rimawi D, Abu-Nasser M, Abu Farsakh F, Hui D. Validation of the Arabic Version of the Edmonton Symptom Assessment System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2571. [PMID: 36767943 PMCID: PMC9915286 DOI: 10.3390/ijerph20032571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Quality cancer care is a team effort. In addition, patients' symptoms change over the course of treatment. As such, the Edmonton Symptom Assessment System (ESAS) is a simple tool designed to quickly monitor symptom change. Here, we present the results from a two-phase study aimed at validating the Arabic version of the ESAS (ESAS-A). Phase one involved the creation of two versions of the ESAS with both reverse and forward translations by bilingual, native Arabic speakers as well as evaluation by an expert panel. The reconciled version was then administered to 20 patients as a pilot from which to create the final version, which was then used with 244 patients. Phase two for the ESAS-involved an ESAS-based validation of 244 adults aged 18 years and older who were diagnosed with advanced cancer; then, further validation was completed in conjunction with two other symptom survey tools, the EORTC-Pal 15 and the HADS. The ESAS-A items possessed good internal consistency with an average Cronbach's alpha of 0.84, ranging from 0.82 to 0.85. Moreover, the results of ESAS-A showed good agreement with those of EORTC QLQ- 15 PAL (r = 0.36 to 0.69) and HADS (r = 0.60 and 0.57) regarding anxiety and depression. We found the ESAS-A to be responsive to symptom change and a median time to completion of 3.73 min. The results of our study demonstrate that the ESAS-A is a reliable, valid, and feasible tool for the purposes of monitoring symptom change over the course of cancer treatment.
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Affiliation(s)
- Omar Shamieh
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman 11941, Jordan
- Faculty of Medicine, the University of Jordan, Amman 11942, Jordan
| | - Ghadeer Alarjeh
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman 11941, Jordan
| | - Mohammad Al Qadire
- Adult Health Department, Faculty of Nursing, Al Al-Bayt University, Mafraq 25113, Jordan
- College of Nursing, Sultan Qaboos University, Muscat 123, Oman
| | - Zaid Amin
- Department of Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | | | - Mohammad Al-Omari
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Omar Mohtadi
- Department of Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Abdullah Illeyyan
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Omar Ayaad
- Sultan Qaboos Comprehensive Cancer Center Care and Research Center, Muscat P.O. Box 566 PC 123, Oman
| | - Sawsan Al-Ajarmeh
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman 11941, Jordan
| | - Amal Al-Tabba
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Khawlah Ammar
- Center of Research Shared Resources, King Hussein Cancer Center, Amman 11941, Jordan
| | - Dalia Al-Rimawi
- Center of Research Shared Resources, King Hussein Cancer Center, Amman 11941, Jordan
| | - Mahmoud Abu-Nasser
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
- Department of Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Fadi Abu Farsakh
- Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - David Hui
- MD Anderson Cancer Center, Houston, TX 77030, USA
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Limsomwong P, Ingviya T, Fumaneeshoat O. The trend of opioid prescriptions among cancer patients in a tertiary hospital: A multimethod quantitative study. Front Oncol 2023; 13:1138169. [PMID: 37114139 PMCID: PMC10128996 DOI: 10.3389/fonc.2023.1138169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Pain is a major symptom in cancer patients. World Health Organization recommends opioids as the main analgesic agent. Few studies have examined the amount of opioid uses in cancer patients in Southeast Asia, however, none of them have examined the factors associated with the amount of opioid uses which were lower than required. Objectives To assess the trends and factors associated with opioid prescriptions for cancer patients in Songklanagarind Hospital, the largest referral center in Southern Thailand. Design Multi-method quantitative study. Methods We reviewed the electronic medical records of 20,192, outpatients aged ≥18 years diagnosed with cancer between 2016 and 2020 who received opiod prescriptions. Oral morphine equivalents (OME) were calculated using the standard conversion factors and the OME trend during the study period was assessed by a generalized additive model. Factors affecting the morphine equivalent daily dose (MEDD) were assessed using multiple linear regression with a generalized estimating equation. Results The mean overall MEDD for all study patients was 27.8 ± 21.9 mg per day per patient. The bone and articular cartilage cancer patients had the highest MEDD. For every 5-year increase in the duration of cancer, the MEDD increased by 0.02 (95% confidence interval [CI]: 0.01 - 0.04). Patients with stage 4 cancer received a higher average MEDD of 4.04 (95% CI: 0.30-7.62) as compared to those with stage 1 cancer. Patients with bone metastasis received a average higher MEDD of 4.03 (95% CI: 0.82-7.19) compared to those without. Age was inversely associated with the MEDD. Patients aged 42-58, 59-75 and >76years old received MEDDs of 4.73 (95% CI: 2.31-7.15), 6.12 (95% CI: 3.66-8.59) and 8.59 (95% CI: 6.09-11.09) compared with those aged 18-42 years old. Brain metastasis was inversely associated with MEDD of 4.49 (95% CI: 0.61-8.37) compared to those without. Conclusion Opioid use in cancer patients in this study is lower than the average global usage. Promoting opioid prescriptions for pain management through medical education can help doctors overcome opiophobia.
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Affiliation(s)
- Pawita Limsomwong
- Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Thammasin Ingviya
- Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Orapan Fumaneeshoat
- Department of Family and Preventive Medicine, Prince of Songkla University, Songkhla, Thailand
- *Correspondence: Orapan Fumaneeshoat,
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Fradelos EC, Albani E, Papathanasiou IV, Prapa PM, Tsomaka E, Bakalis V, Artemi S, Lavdaniti M. Spiritual Needs of Lung Cancer Patients and Their Relation to Psychological Distress and Quality of Life. Cureus 2021; 13:e20225. [PMID: 35004042 PMCID: PMC8733845 DOI: 10.7759/cureus.20225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 11/05/2022] Open
Abstract
Background This study aimed to investigate the spiritual needs of patients suffering from lung cancer in relation to their mental health and quality of life. Methodology A cross-sectional quantitative study design was employed to investigate 110 lung cancer patients receiving chemotherapy. A four-part self-assessment instrument was used to gather the data comprising a sheet containing demographic and clinical information, Spiritual Needs Questionnaire, The Depression, Anxiety, and Stress Scale-21 Items, and the 12-item Health Survey. Descriptive inferential statistics were applied. Results Of the 110 patients, 71.8% were men, the mean age was 64.25 (±9.3) years, and 71.8% were married. In total, 40.9% of the patients were retired, and 92.7% had a public insurance company. Regarding education, 30% were primary school graduates and 31.8% were high school graduates. Regarding the clinical features of the sample, 23.6% of the patients had small-cell carcinoma, 71.9% had non-small-cell carcinoma, and 4.5% had large-cell carcinoma. Spiritual needs have a negative effect on the mental health component of quality of life (p < 0.001) and can increase psychological distress in lung cancer patients. Conclusions In contrast to the findings of other international studies, spiritual needs appeared to be lower; however, similar to other studies, spiritual needs increased in those suffering from depression and anxiety. Moreover, the subtype of lung cancer also appeared to play a role.
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Souliotis K, Peppou LE, Economou M, Marioli A, Nikolaidi S, Saridi M, Varvaras D, Paschali A, Syrigos KN. Treatment Adherence in Patients with Lung Cancer from Prospects of Patients and Physicians. Asian Pac J Cancer Prev 2021; 22:1891-1898. [PMID: 34181348 PMCID: PMC8418830 DOI: 10.31557/apjcp.2021.22.6.1891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: Adherence to treatment can be defined as the degree to which a patient’s behavior is consonant with medical or health advice he or she receive as part of his treatment regimen. The aim of this study was: 1) to measure the rate of treatment adherence to among patients with lung cancer from the prospect of both patients and physicians, 2) to measure the degree of concordance between the two prospect, and 3) to identify factors related to adherence for both prospect (patients and physicians). Materials and Methods: A total of 250 patients were included in this study. Information about socio-economic characteristics, depressive and anxiety symptoms (Hospital Anxiety and Depression scale), nicotine dependence (Fagerstrom scale), barriers to accessing care, and the level of treatment adherence was collected through interview. Physicians were enquired about disease and treatment variables as well as patients’ level of adherence. Results: From the patient perspective, only 1.2% of patients displayed poor adherence; whereas the corresponding percentage among physicians was 12.4%. The concordance between the two was low: 0.244. The correlation of measurements made on the same individual was found to be equal to 0.14. Barriers to accessing medication (O.R.=2.82, 95% C.I.: 1.01-8.09) was the only risk factor when adherence was self-rated; barriers to accessing medication (O.R.=2.45, 95% C.I.: 1.03-5.86), education equal to 12 years (O.R.=0.33, 95% C.I.: 0.13-0.82) or higher than 12 years (O.R.=0.28, 95% C.I.: 0.08-0.96), nicotine dependence (O.R.=1.41, 95% C.I. 1.17-1.69) and HADS anxiety score (O.R.=1.15, 95% C.I. 1.03-1.30) were the predictors in physicians’ rating. Conclusions: Differences in rating adherence may underpin communication gaps between patients and physicians. Systemic determinants of poor adherence should not be overlooked. A concerted effort by researchers, physicians and policy makers in defining as well as communicating adherence, while removing its barriers should be made.
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Affiliation(s)
- Kyriakos Souliotis
- Faculty of Social & Political Sciences, University of Peloponnese, Corinth, Greece.,School of Nursing, University of Thessaly Greece
| | - Lily E Peppou
- School of Nursing, University of Thessaly Greece.,Community Mental Health Centre, University Mental Health Research Institute (UMHRI), Athens, Greece
| | - Marina Economou
- Community Mental Health Centre, University Mental Health Research Institute (UMHRI), Athens, Greece.,First Department of Psychiatry, Aiginition Hospital, Medical School, Kapodistrian University of Athens, Athens, Greece
| | - Androniki Marioli
- Division of Medical Oncology, Third Department of Medicine, Kapodistrian University of Athens, Athens, Greece
| | | | - Maria Saridi
- School of Nursing, University of Thessaly Greece
| | | | - Antonia Paschali
- Faculty of Nursing, School of Health Sciences, Department of Mental Health and Behavioral Sciences, Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos N Syrigos
- Division of Medical Oncology, Third Department of Medicine, Kapodistrian University of Athens, Athens, Greece
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Chua GP, Pang GSY, Yee ACP, Neo PSH, Zhou S, Lim C, Wong YY, Qu DL, Pan FT, Yang GM. Supporting the patients with advanced cancer and their family caregivers: what are their palliative care needs? BMC Cancer 2020; 20:768. [PMID: 32799834 PMCID: PMC7429720 DOI: 10.1186/s12885-020-07239-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 07/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background The impact and consequences of cancer on the patients and their family caregivers (FCs) are closely intertwined. Caregivers’ burdens can be increased due to the patients’ unmet needs and unresolved problems. Additionally, the caregivers’ unmet needs may adversely affect their own well-being and the patients’ health outcomes. This study aims to determine the palliative care needs and the factors associated with these needs in patients with advanced solid cancer and their FCs. Methods In a cross-sectional survey, 599 patients with advanced solid tumours and 599 FCs were recruited from the largest ambulatory cancer centre and the inpatient ward of the largest hospital in Singapore. Determinants of patients’ and FCs’ needs were assessed by the Comprehensive Needs Assessment Tool (CNAT) and CNAT-C respectively. Clinical characteristics of patients were obtained from medical records. Results The FCs (median age 51 years) were younger than the patients (median age 62 years), and were mostly female (62.6%) whereas the gender distribution of patients was quite balanced (49.2% male and 50.8% female). Both patients and FCs had “information” and “practical support” in their top three domains of palliative care needs. The second highest domain of needs was “psychological problems” (16.4 ± 21.5) in patients and “health-care staff” (23.4 ± 26.5) in FCs. The item that had the highest need score in “information” domain for both patients and FCs was “financial support for patients, either from government and/ or private organizations”. Under clinical setting, the inpatients (19.2 ± 16.4) and their FCs (26.0 ± 19.0) tend to have higher needs than the outpatients (10.5 ± 12.1) and their FCs (14.7 ± 14.3). In terms of palliative care, higher total CNAT score was observed in both patients (16.6 ± 12.9 versus 13.3 ± 15.2) and their FCs (25.1 ± 18.6 versus 17.7 ± 16.7) who received palliative care. In terms of patients’ KPS scores, patients with lower KPS scores tend to have higher needs. Conclusion Overall, the findings confirm that patients with advanced cancer and their FCs have many palliative care needs irrespective of their clinical settings. Initiatives and interventions for the development of a comprehensive support system for both patients with advanced cancer and their FCs are warranted and can be derived from these findings.
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Affiliation(s)
- Gek Phin Chua
- CEIS (Research & Data), National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, Singapore, 169610, Singapore.
| | | | - Alethlea Chung Pheng Yee
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Patricia Soek Hui Neo
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Siqin Zhou
- Division of Clinical Trails and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Cindy Lim
- Division of Clinical Trails and Epidemiological Sciences, National Cancer Centre Singapore, Singapore, Singapore
| | - Yin Yee Wong
- Quality department, Assisi Hospice, Singapore, Singapore
| | - Debra Limin Qu
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Grace Meijuan Yang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
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