Symptom Screening Rates Have Declined for Patients With Head and Neck Cancer

Edmonton Symptom Assessment System (ESAS) completion rates need to be improved to ensure that head and neck cancer (HNC) symptoms are effectively addressed, according to a study presented at the 2024 American Society of Clinical Oncology Annual Meeting.

“High completion rates provide valuable data for cancer centers and clinicians to intervene early and support patients through their cancer journey. This makes it an important target for quality improvement (QI), with wide-ranging implications for patient outcomes and care quality,” the researchers noted.

In this QI project targeting study, researchers assessed a patient population with HNC at a regional cancer center. They aimed to analyze stakeholder engagement using the expertise of QI specialists. Comprehensive data collection was conducted to analyze symptom screening rates and identify potential barriers to ESAS completion.

Subsequently, ESAS completion on weekly HNC clinic days was analyzed from 2022 to 2023 using manual and automated chart abstraction. The researchers also conducted patient, staff, and volunteer interviews, along with direct clinic observations to discern root causes for lack of completion.

Following analysis, the researchers observed an appreciable decline in ESAS completion rates, steadily decreasing from an average of 29.4% during the 2022-2023 fiscal year to an average of 7.6% between April and November 2023, with rates dropping as low as 3.3% in September 2023. The root cause analysis identified several barriers to ESAS completion, including the transition from paper-based assessments used during the pandemic to electronic formats, low patient awareness of the purpose of symptom screening, perceived lack of value in screening by patients and staff, and the absence of direct guidance from staff in helping patients complete their ESAS. Improving infrastructure and support for volunteer services was pinpointed as a potential solution.

“The project has laid the foundation for targeted QI interventions aimed at improving ESAS screening adherence. By addressing the identified barriers, this work endeavors to re-engage patients in active symptom reporting and to integrate this critical aspect of care into the daily routine of the outpatient hospital setting, thereby enhancing the overall management of HNC symptoms,” the researchers noted.

Reference

Jonas K, Li H, Wong B, et al. Improving symptom screening rates for patients with head and neck cancer. Abstract #e23246. Published for the 2024 American Society of Clinical Oncology Annual Meeting; May 31-June 4, 2024; Chicago, Illinois.