Abstract
Predictors of Symptom Reporting Concordance Between Patient and Provider in the Context of Cancer and Multimorbidity (GP725)
Journal of pain and symptom management, Vol.63(6), pp.1125-1126
06/01/2022
DOI: 10.1016/j.jpainsymman.2022.04.116
Abstract
Outcomes. 1. Describe concordance of patient and provider reports of symptoms 2. Discuss the factors associated with symptom concordance and the impact of multimorbidity Importance. The impact of multimorbidity on concordance between patient reports and provider documentation of symptoms in electronic health record (EHR) clinical notes in the context of cancer has been minimally studied. Objective(s). To measure concordance of patient and provider reports of cancer symptoms and examine the effect of multimorbidity on concordance rates. Method(s). This cross-sectional analysis examined concordance of patient and provider reports of 13 common cancer symptoms. Provider reports of symptoms were data-mined from EHR clinical notes using NimbleMiner. Patient reports of symptoms were collected with a validated self-report measure. Kappa scores were calculated to measure concordance of symptom reports. Multiple linear regression was conducted to identify factors associated with concordance of patient and provider reports of symptoms. Results. A sample of 204 notes from n = 125 patients were included in the analysis. The mean age was 57 (± 13.1) years, 56.8% were women, and approximately half the sample had stage IV cancer and high comorbidity (≥2 diagnoses); 75% of the notes were from an outpatient visit. The most reported symptoms by both patients and providers were fatigue (66.7%) and pain (74%), overall concordance of symptoms was 55.3%, and the most concordant and discordant symptoms were pruritus (74%) and fatigue (56.8%). Multiple linear regression showed that patients with advanced stage cancer (β = –.211, p = .007) and high comorbidity (β = –.179, p =.042) had significantly lower concordance rates. Conclusion(s). Fatigue had the lowest concordance rate in this analysis. Advanced stage disease and multimorbidity were associated with lower concordance. Fatigue is often seen as a symptom one must simply accept, which may contribute to the lack of concordance in reporting. Impact. Patients with cancer and multimorbidity may have difficulty determining the cause of their symptoms and do not know with whom to discuss their symptoms. Integration of a patient-reported symptom report into the EHR would facilitate increased assessment of common distressing symptoms and promote provider awareness of symptoms.
Details
- Title: Subtitle
- Predictors of Symptom Reporting Concordance Between Patient and Provider in the Context of Cancer and Multimorbidity (GP725)
- Creators
- Stephanie Gilbertson-WhiteAlaa AlbashayrehCatherine CherwinAnindita Bandyopadhyay
- Resource Type
- Abstract
- Publication Details
- Journal of pain and symptom management, Vol.63(6), pp.1125-1126
- DOI
- 10.1016/j.jpainsymman.2022.04.116
- ISSN
- 0885-3924
- eISSN
- 1873-6513
- Publisher
- Elsevier Limited
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Nursing; Internal Medicine
- Record Identifier
- 9984362746202771
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