Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-23T04:31:43.197Z Has data issue: false hasContentIssue false

The PERSONS score: A new tool for cancer patients’ symptom assessment in simultaneous care and home care settings

Published online by Cambridge University Press:  22 August 2019

Alessio Cortellini*
Affiliation:
Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Giampiero Porzio
Affiliation:
Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Vincenza Cofini
Affiliation:
Biostatistics and Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
Stefano Necozione
Affiliation:
Biostatistics and Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
Alessandro Parisi
Affiliation:
Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Flaminia Peris
Affiliation:
Tuscany Tumors Association, Home Care Service, Florence, Italy
Giulio Ravoni
Affiliation:
Tuscany Tumors Association, Home Care Service, Florence, Italy
Giuseppe Spinelli
Affiliation:
Tuscany Tumors Association, Home Care Service, Florence, Italy
Eva K. Masel
Affiliation:
Clinical Division of Palliative Care, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Anna S. Berghoff
Affiliation:
Clinical Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria.
Corrado Ficorella
Affiliation:
Medical Oncology Unit, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
Lucilla Verna
Affiliation:
Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
*
Corresponding author: Alessio Cortellini, MD Medical Oncology Unit, St. Salvatore Hospital Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila Via Vetoio, 67100, L'Aquila, Italy. Email: [email protected]

Abstract

Background

Scientific societies recommend early interaction between oncologic and supportive care, but there is still a lack of systematic evaluations regarding symptoms from the perspective of oncologists.

Patients and methods

The aim of this prospective study was to evaluate the PERSONS score, in both “simultaneous care” and “supportive care” settings using the Edmonton Symptom Assessment Scale (ESAS) as a comparator.

Results

From November 2017 to April 2018, 67 and 110 consecutive patients were enrolled in outpatient and home care cohorts, respectively. The final study population comprised 163 patients. There were no significant changes over time in the total PERSONS scores and total ESAS scale. The intra-interviewer reliability (ICC2,1) and inter-interviewer reliability (ICC2,k) showed good reproducibility (test-retest) in each group of patients: 0.60 (0.49–0.70) and 0.82 (0.75–0.87), respectively, for the home care patients and 0.73 (0.62–0.81) and 0.89 (0.83–0.93), respectively, for the outpatient cohort. There were high correlations between PERSONS and ESAS, both at the baseline and final assessments. The mean PERSONS and ESAS scores between the home care patients and outpatients were not different at the baseline and final assessments. Receiver operating characteristics (ROC) curve for the PERSONS total score revealed good diagnostic ability. Area under the curve (AUC) was 0.825 and 0.805 for improvement and deterioration, respectively.

Conclusions

The PERSONS score is an easy to apply tool for symptom assessment. Importantly, the PERSONS score showed high concordance with the established ESAS scale and, therefore, provides an alternative for everyday use in supportive care assessment.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bakitas, MA, Tosteson, TD, Li, Z, et al. (2015) Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial. Journal of Clinical Oncology 33(13), 14381445.CrossRefGoogle ScholarPubMed
Basch, E, Deal, AM, Dueck, AC, et al. (2017) Overall Survival Results of a Trial Assessing Patient Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. JAMA 318(2), 197198.CrossRefGoogle ScholarPubMed
Bruera, E, Kuehn, N, Miller, MJ, et al. (1991) The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care 7(2), 69.CrossRefGoogle ScholarPubMed
Chang, VT, Hwang, SS, and Feuerman, M (2000) Validation of the Edmonton Symptom Assessment Scale. Cancer 88(9), 21642171.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Cortellini, A, Porzio, G, and Masel, EK (2018) The PERSONS score for symptoms assessment in simultaneous care setting: A pilot study. Palliative & Supportive Care 24, 15.Google Scholar
Davis, MP, Strasser, F, and Cherny, N (2015) How well is palliative care integrated into cancer care? A MASCC, ESMO, and EAPC Project. Supportive Care in Cancer 23(9), 26772685.CrossRefGoogle Scholar
Davis, MP, Temel, JS, Balboni, T et al. (2015) A review of the trials which examine early integration of outpatient and home palliative care for patients with serious illnesses. Annals of Palliative Medicine 4(3), 99121.Google ScholarPubMed
Evans, JD, Pacific, Grove (1996) Straightforward Statistics for the Behavioral Sciences. CA: Brooks/Cole Publishing.Google Scholar
Ferrell, BR, Temel, JS, and Temin, S (2017) Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline Update. Journal of Oncology Practice / American Society of Clinical Oncology 13(2), 119121.CrossRefGoogle Scholar
Giusti, R, Verna, L, Iacono, D, et al. (2017) Knowledge and attitudes of young Italian medical oncologists toward the approach and treatment of pain: no changes, despite the law. Pain Medicine 18(9), 18221824.CrossRefGoogle ScholarPubMed
Grávalos, C, Salvador, J, Albanell, J, et al. (2012) Functions and workload of medical oncologists in Spain. Clinical and Translational Oncology 14(6), 423429.CrossRefGoogle ScholarPubMed
Greer, JA, Jackson, VA, Meier, DE, et al. (2013) Early integration of palliative care services with standard oncology care for patients with advanced cancer. Cancer Journal for Clinicians, 63(5), 349363.CrossRefGoogle ScholarPubMed
Haun, MW, Estel, S, Rücker, G, et al. (2017) Early palliative care for adults with advanced cancer. Cochrane Database of Systematic Reviews 6(6), CD011129.Google ScholarPubMed
Hui, D, Shamieh, O, Paiva, CE, et al. (2015) Minimal clinically important differences in the Edmonton Symptom Assessment Scale in cancer patients: A prospective, multicenter study. Cancer 121(17), 30273035.CrossRefGoogle ScholarPubMed
Koo, TK and Li, MY (2016) A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. Journal of Chiropractic Medicine 15(2), 155163.CrossRefGoogle ScholarPubMed
Masel, EK, Berghoff, AS, Schur, S, et al. (2016) The PERS(2) ON score for systemic assessment of symptomatology in palliative care: A pilot study. European Journal of Cancer Care, 25(4), 544550.CrossRefGoogle ScholarPubMed
Moro, C, Brunelli, C, Miccinesi, G, et al. (2006) Edmonton symptom assessment scale: Italian validation in two palliative care settings. Supportive Care in Cancer 14(1), 3037.CrossRefGoogle ScholarPubMed
Pereira, JL, Chasen, MR, Molloy, S, et al. (2016) Cancer care professionals’ attitudes toward systematic standardized symptom assessment and the edmonton symptom assessment system after large-scale population-based implementation in Ontario, Canada. Journal of Pain and Symptom Management 51(4), 662672. e8.CrossRefGoogle ScholarPubMed
Portney Gross, L and Watkins, MP. (2009) Foundations of clinical research: applications to practice. Upper Saddle River, NJ: Pearson/Prentice Hall.Google Scholar
Porzio, G, Valenti, M, Aielli, F, et al. (2005) Assessment and treatment of symptoms among Italian medical oncologists. Supportive Care in Cancer 13(11), 865869.CrossRefGoogle ScholarPubMed
Shrout, PE and Fleiss, JL (1979) Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin 86(2), 420428.CrossRefGoogle ScholarPubMed
Temel, JS, Greer, JA, Muzikansky, A, et al. (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. The New England Journal of Medicine 363(8), 733742.CrossRefGoogle ScholarPubMed
Verna, L, Giusti, R, Marchetti, P, et al. (2016) Integration between oncology and palliative care: Does one size fit all? Annals of Oncology : Official Journal of the European Society for Medical Oncology 27(3), 549.CrossRefGoogle ScholarPubMed
Zagonel, V, Franciosi, V, Brunello, A, et al. (2017) Position paper of the Italian Association of Medical Oncology on early palliative care in oncology practice (Simultaneous Care). Tumori 103(1), 914.CrossRefGoogle Scholar
Zagonel, V, Torta, R, Franciosi, V, et al. (2016) Early Integration of Palliative Care in Oncology Practice: Results of the Italian Association of Medical Oncology (AIOM) Survey. Journal of Cancer 7(14), 19681978.CrossRefGoogle ScholarPubMed
Supplementary material: File

Cortellini et al. supplementary material

Cortellini et al. supplementary material
Download Cortellini et al. supplementary material(File)
File 13.2 KB