Background:
Identification and management of supportive care needs in Victoria’s cancer population is a key priority area of the cancer reform agenda. Systematic screening using the NCCN Distress Thermometer and Problem Checklist (DT) commenced in 2010. In 2013 a state-wide review of a sample of the screened population was agreed.
Aim:
Evaluate the distress, needs and outcomes from supportive care screens in Victoria.
Use the findings at a local and state level to address service gaps and plan services to address identified need.
Methods:
A state-wide retrospective audit was undertaken on a sample of the newly diagnosed, screened cancer population. Screening tool data and additional information about the patient, their cancer, treatment and action taken were collected. Distress scores were categorised into low (<4), medium (4-8) and high (8-10). Analysis by region, tumour type, screening location, problems identified and screening outcomes was undertaken.
Results:
A total of 463 individual supportive care screens were audited. The breakdown of distress scores by category was consistent across the state and reflected international findings. Tumour types most commonly screened include: breast, colorectal, haematological, lung and upper gastro-intestinal. Breast, gynaecological and lung patients recorded the greatest proportion of distress with over 60% of cases identifying a distress score of 4 or above. The median number of problems identified per person was 5. In the emotional domain: worry (49%), nervousness (46%), sadness (34%), fears (32%) and depression (20%); and in the physical domain: fatigue (45%), sleep (41%), pain (28%) and memory (21%) were most commonly identified. Further data analysis into relationships between disease, treatment, problems and screening outcomes is underway.
Conclusion:
Standardised detailed data collection of supportive care screening does provide valuable information about supportive care needs of the cancer population and can be used to guide service improvement to address identified need.