Symptom guides were perceived as helpful by nurses conducting telephone-based follow-up care for patients with cancer undergoing chemotherapy, according to results of a retrospective study published in Oncology Nursing Forum.1
Previous studies support the role of oncology nurse navigation or nurse-led oncology care coordination in facilitating appropriate use of health care resources and improving outcomes for patients with cancer.
“Collectively, challenges related to quality, costs, and patient illness complexity have generated urgency and a national mandate to transform cancer care delivery, with care coordination emerging as a promising solution,” the study authors stated.
However, “surprisingly little evidence quantifies or describes the specific nursing activities that comprise [nurse]-led care coordination.”
This study was performed as a secondary analysis of data collected as part of a randomized study evaluating nurse-led, telephone-based symptom management with or without a mobile health application for patients with newly diagnosed cancer who were initiating chemotherapy (ClinicalTrials.gov Identifier: NCT02238951). Related data on nurse-led care coordination activities entered into the patient electronic health record during the course of the clinical trial were accessed for this study.
Care was coordinated by 3 nurses who were not specialists in oncology patient care. Before the nurse-led telephone encounters, patients were asked to evaluate chemotherapy-related symptom severity using the Edmonton Symptom Assessment Scale,2 and based on patient responses, oncology care coordinators selected the most appropriate pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) tool to facilitate the patient encounter. These telephone-based meetings were scheduled every 2 weeks for up to 6 months.
Of the 52 patients who participated in the study, 21 completed 6 months of care coordination. Some key findings included the following:
- The average length of care coordination was 4.8 months and the average number of encounters between the nurse and the patient was 11.4
- The average lengths of the initial assessment call and follow-up calls were 90 minutes and 30 minutes, respectively
- Collectively, patients reported fatigue/tiredness, nausea/vomiting, pain, peripheral neuropathy, constipation, and depression as the most bothersome symptoms of chemotherapy
- Nurses made 15 referrals to cancer-specific resources, including peer support groups
- Nurses reported that in early telephone encounters their focus was on symptom management but shifted to more of a supportive role in later encounters
- In general, the nurse care coordinators perceived the symptom guides to be very helpful in facilitating patient care
In conclusion, the study investigators recommend future research efforts examine the influence of preemptive symptom support from oncology nurses regarding patient experiences, health outcomes, and health resource utilization.
Disclosures: Multiple authors reported affiliation with industry or receiving research funding from pharmaceutical companies. Please refer to the original article for a full list of disclosures.
1. Davis A, Bell JF, Reed SC, Kim KK, Stacey D, Joseph JG. Nurse-led telephonic symptom support for patients receiving chemotherapy. Oncol Nurs Forum. 2020;47(6):E199-E120. doi:10.1188/20.ONF.E199-E210
2. Chang VT, Hwang SS, Feuerman M. Validation of the Edmonton Symptom Assessment Scale.Cancer. 2000;88:2164-2171. doi:10.1002/(sici)1097-0142(20000501)88:9<2164::aid-cncr24>3.0.co;2-5