Quality of supportive care for patients with advanced cancer in a VA medical center

Jennifer L. Malin, Sean M. O'Neill, Steven M. Asch, Sydney E Dy, Anne M. Walling, Diana Tisnado, Anna Liza Antonio, Karl A. Lorenz

Research output: Contribution to journalArticle

Abstract

Purpose: Using the Assessing Symptoms Side Effects and Indicators of Supportive Treatment (ASSIST) quality indicators (QIs), we conducted a comprehensive evaluation of the quality of care provided in our institution to patients diagnosed with advanced cancer in 2006. Methods: Patients diagnosed with a Stage IV solid tumor were identified from the hospital's cancer registry. Using data abstracted from medical records, care was assessed using 41 explicit QIs. Mean percent adherence to QIs was calculated overall, as well as across five clinical domains: (1) Pain, (2) Depression and Psychosocial Distress, (3) Dyspnea, (4) Treatment Toxicity, (5) Other Symptoms, and (6) Information and Care Planning. Results: The study cohort (n = 118) was almost all male (2% female) and mean age was 65.9 years (standard deviation [SD] 9.9 years). The most common cancers were lung and head and neck cancer (23% each); 17% had prostate cancer; 13% had colorectal cancer; and the rest (24%) had breast, esophageal, stomach, genitourinary, liver/biliary, or pancreas cancer. Patients received 51% (95% confidence interval [CI] 48%-54%) of recommended care. Adherence to recommended care within domains ranged from 38% (95% CI 35%-42%) for Other Symptoms to 79% (95% CI 73%-86%) for Information and Care Planning. Conclusions: This study suggests that the quality of supportive care for patients with advanced cancer can be greatly improved. Future efforts should use the ASSIST indicators to evaluate the quality of supportive care in larger and more diverse cohorts of advanced cancer patients.

Original languageEnglish (US)
Pages (from-to)573-577
Number of pages5
JournalJournal of Palliative Medicine
Volume14
Issue number5
DOIs
StatePublished - May 1 2011

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Quality of Health Care
Confidence Intervals
Neoplasms
Head and Neck Neoplasms
Lung Neoplasms
Cancer Care Facilities
Liver Neoplasms
Pancreatic Neoplasms
Dyspnea
Medical Records
Registries
Colorectal Neoplasms
Prostatic Neoplasms
Stomach
Breast
Cohort Studies
Therapeutics
Depression
Pain

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

Malin, J. L., O'Neill, S. M., Asch, S. M., Dy, S. E., Walling, A. M., Tisnado, D., ... Lorenz, K. A. (2011). Quality of supportive care for patients with advanced cancer in a VA medical center. Journal of Palliative Medicine, 14(5), 573-577. https://doi.org/10.1089/jpm.2010.0464

Quality of supportive care for patients with advanced cancer in a VA medical center. / Malin, Jennifer L.; O'Neill, Sean M.; Asch, Steven M.; Dy, Sydney E; Walling, Anne M.; Tisnado, Diana; Antonio, Anna Liza; Lorenz, Karl A.

In: Journal of Palliative Medicine, Vol. 14, No. 5, 01.05.2011, p. 573-577.

Research output: Contribution to journalArticle

Malin, JL, O'Neill, SM, Asch, SM, Dy, SE, Walling, AM, Tisnado, D, Antonio, AL & Lorenz, KA 2011, 'Quality of supportive care for patients with advanced cancer in a VA medical center', Journal of Palliative Medicine, vol. 14, no. 5, pp. 573-577. https://doi.org/10.1089/jpm.2010.0464
Malin, Jennifer L. ; O'Neill, Sean M. ; Asch, Steven M. ; Dy, Sydney E ; Walling, Anne M. ; Tisnado, Diana ; Antonio, Anna Liza ; Lorenz, Karl A. / Quality of supportive care for patients with advanced cancer in a VA medical center. In: Journal of Palliative Medicine. 2011 ; Vol. 14, No. 5. pp. 573-577.
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