Perceptions of Toxicity Burden for Patients Treated for Cancer Differ Among Clinicians

In a recent study, nurses and physicians showed differences in their perceptions of the severity of adverse events (AEs) experienced by patients, with results published in Health and Quality of Life Outcomes.

In this study, 14 nurses with backgrounds in research oncology examined AE reports from 334 patients who each reported at least 1 AE while participating in a SWOG Cancer Research Network clinical trial. Patient AE reports were assessed by 2 nurses each, who scored AE burden on a scale from 0 to 10. Results were averaged for each patient, and a higher number reflected a higher burden. The nurses’ averaged scores were compared with scores for the same AEs that had been previously estimated by physicians.

In this study, the nurses’ averaged scores showed a mean value of 5.44 for global AE burden, which was marginally higher than the mean score of 5.14 that was determined by the physicians (P <.001).

The nurses and physicians showed a percent agreement of 78% in rating patients with a score of 6 or higher. However, as less severe AEs were included, nurses and physicians showed more divergence in their assessments, with a percent agreement of 64% when considering scores of 4 or higher. Nurses also tended to rate symptomatic AEs as being significantly more burdensome than they were in physicians’ assessments.

Both nurses and physicians perceived multiple AEs in a patient as raising the patient’s overall symptom burden, but the researchers noted that AEs are typically not reported in terms of overall toxicity burden. To address this, the researchers provided formulas for nurses and physicians to use in estimating a patient’s overall toxicity burden in order to optimize patient care.

Reference

Lee SM, Miao J, Wu R, Unger JM, Cheung K, Hershman DL. A comparison of nurses’ and physicians’ perception of cancer treatment burden based on reported adverse events. Health Qual Life Outcomes. 2019;17(1):146.