Feasibility of three times weekly symptom screening in pediatric cancer patients

Maryann Calligan; Lauren Chakkalackal; Grace Dadzie; Cassandra Tardif-Theriault; Sadie Cook; Emily Vettese; Dilip Soman; Susan Kuczynski; Tal Schechter; L Lee Dupuis; Lillian Sung

doi:10.1186/s12885-022-10400-1

Feasibility of three times weekly symptom screening in pediatric cancer patients

BMC Cancer. 2023 Jan 3;23(1):4. doi: 10.1186/s12885-022-10400-1.

Authors

Affiliations

¹ Program in Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada.
² Rotman School of Management, University of Toronto, 105 St. George Street, Toronto, ON, M5S 3E6, Canada.
³ Ontario Parents Advocating for Children with Cancer (OPACC), 99 Citation Drive, Toronto, ON, M2K 1S9, Canada.
⁴ Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
⁵ Department of Pharmacy, The Hospital for Sick Children, and Leslie Dan Faculty of Pharmacy, University of Toronto, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
⁶ Program in Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada. lillian.sung@sickkids.ca.
⁷ Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. lillian.sung@sickkids.ca.

Abstract

Objective: Primary objective was to determine the feasibility of three times weekly symptom reporting by pediatric cancer patients for eight weeks.

Methods: We included English-speaking patients 8-18 years of age with cancer. Patients were sent reminders by text or email to complete Symptom Screening in Pediatrics Tool (SSPedi) three times weekly for eight weeks. When patients reported at least one severely bothersome symptom, the symptom report was emailed to the primary healthcare team. Patient-reported outcomes were obtained at baseline, week 4 ± 1 and week 8 ± 1. Symptom documentation, intervention provision for symptoms and unplanned healthcare encounters were determined by chart review at weeks 4 and 8. The primary endpoint was feasibility, defined as at least 75% patients achieving adherence with at least 60% of SSPedi evaluations. We planned to enroll successive cohorts until this threshold was met.

Results: Two cohorts consisting of 30 patients (cohort 1 (n = 20) and cohort 2 (n = 10)) were required to meet the feasibility threshold. In cohort 1, 11/20 (55%) met the SSPedi completion threshold. Interventions applied after cohort 1 included engaging parents to facilitate pediatric patient self-report, offering mechanisms to remember username and password and highlighting potential benefits of symptom feedback to clinicians. In cohort 2, 9/10 (90%) met the SSPedi completion threshold and thus feasibility was met. Patient-reported outcomes and chart review outcomes were obtained for all participants in cohort 2.

Conclusions: Three times weekly symptom reporting by pediatric patients with cancer for eight weeks was feasible. Mechanisms to enhance three times weekly symptom reporting were identified and implemented. Future studies of longitudinal symptom screening can now be planned.

Keywords: Oncology; Pediatric; Quality of life; Symptom screening.

MeSH terms

Child
Early Detection of Cancer*
Feasibility Studies
Humans
Neoplasms* / complications
Neoplasms* / diagnosis
Psychometrics
Symptom Assessment