Four questions: Daily assessment of pain, anxiety, problems or concerns, and need to see physician during a course of radiation therapy.

Abstract

62 Background: Patients (Pts) undergoing radiation therapy (RT) as part of their treatment (Rx) for a malignancy may have pain, distress, anxiety or other problems at the time of initiation of RT. Pts may also develop or have an exacerbation one or more of the above during RT. During RT, pts are seen weekly by the treating physician (MD), and are seen daily by the treating radiation therapy technologists (RTT) as they undergo Rx. Pts may develop problems between weekly MD visits which may benefit from interventions. A system was developed where pts would be asked four questions each treatment day by the RTT: 1) Are you having pain, and if so, how would you rate it on a scale of zero to 10? (PainQ) 2) Are you having anxiety today? (AQ) 3) Are you having new problems or concerns? (ProConQ) 4) Do you want to see the physician today? (CMDQ) This information was used in pt’s management. Methods: 100 pt charts were reviewed for demographics including gender, age, primary malignancy, region treated, number of Rx and radiation dose. The information from the four question instrument was also reviewed for each pt’s course of RT. Results: Of the 100 pts, 56 were male. Disease distribution: Breast-22; Prostate-20; Head and Neck-20; Lung-13; Brain-7; Other-18. For the AQ, 83 did not report anxiety; 17 reported anxiety on one or two occasions. For the ProConQ, 35 reported none, 34 reported yes on 1 or 2 occasions, 22 reported yes on 3 to 5 occasions, and 9 reported yes on greater than five occasions. 29 reported yes on 2 days in a row, and 15 reported yes to problems or concerns on 3 days in a row. For the PainQ, 31 reported no pain throughout their course of RT, with 22, 23, and 25 reporting pain of any magnitude for 1 to 5, 6 to10, and greater than ten days, respectively. 22 reported pain greater than 6 on at least one occasion. For CMDQ, 26 of pts did not request to see the MD, 71 and 3 requested to see the MD an additional 1 to 5, and 6 to 10 times. Conclusions: A simple instrument prompting a four question query to pts undergoing a course of RT may prompt the need for further evaluation and interventions between scheduled MD visits. This may facilitate more expeditious interventions for Rx related toxicity and treatment dependent or independent symptoms or needs.