TY - JOUR
T1 - Quality Measures for Supportive Cancer Care
T2 - The Cancer Quality-ASSIST Project
AU - Lorenz, Karl A.
AU - Dy, Sydney M.
AU - Naeim, Arash
AU - Walling, Anne M.
AU - Sanati, Homayoon
AU - Smith, Patricia
AU - Shanman, Roberta
AU - Roth, Carol P.
AU - Asch, Steven M.
N1 - Funding Information:
Karl Lorenz is a recipient of a VA Health Services Research & Development Career Development Award. Sydney M. Dy was supported by a K07 award from the National Cancer Institute (K07–CA096783). The views expressed herein do not represent the views of the Department of Veterans Affairs or the sponsor.
Funding Information:
Pilot evaluations funded by the Agency for Healthcare Research and Quality, The National Cancer Institute, and the Veterans Administration using the ASSIST indicators are currently underway. These evaluations will provide critical information that is now lacking about many of these essential practices, and could be of assistance to clinicians who currently lack tools to track their progress. 29,30
Funding Information:
This project was funded by a grant from Amgen to the RAND Corporation.
PY - 2009/6
Y1 - 2009/6
N2 - Patients and physicians often cite symptom control as one of their most important goals in cancer care. Despite this, a previous systematic review found few tools for evaluating the quality of supportive cancer management. We developed a comprehensive set of quality indicators for evaluating pain and nonpain symptom management as well as care planning needs in cancer patients. Based on the prevalence and quality-of-life data, clinician-researchers prioritized pain, psychosocial distress, dyspnea, nausea and vomiting, fatigue and anorexia, treatment-associated toxicities, and information and care planning for quality-indicator development. Using search terms and selection criteria, we identified English-language documents from Medline (1997-2007) and Internet-based searches. Based on this evidence, clinician-reviewers proposed process quality indicators. We then used the VA Health Services Research and Development (VA HSR & D) appropriateness methods to compile the ratings of a multidisciplinary, international expert panel of the validity and feasibility of each indicator. The panel judged 92 out of 133 (69%) proposed quality indicators valid and feasible (15 out of 23 pain, 5 out of 6 depression, 8 out of 11 dyspnea, 15 out of 19 nausea and vomiting, 13 out of 26 fatigue and anorexia, 23 out of 32 other treatment-associated toxicities, and 13 out of 16 information and care planning). Of the final indicators, 67 are potentially useful for inpatient and 81 for outpatient evaluation, and 26 address screening, 12 diagnostic evaluation, 20 management, and 21 follow-up. These quality indicators provide evidence-explicit tools for measuring processes critical to ensuring high-quality supportive cancer care. Research is needed to characterize adherence to recommended practices and to evaluate the use of these measures in quality improvement efforts.
AB - Patients and physicians often cite symptom control as one of their most important goals in cancer care. Despite this, a previous systematic review found few tools for evaluating the quality of supportive cancer management. We developed a comprehensive set of quality indicators for evaluating pain and nonpain symptom management as well as care planning needs in cancer patients. Based on the prevalence and quality-of-life data, clinician-researchers prioritized pain, psychosocial distress, dyspnea, nausea and vomiting, fatigue and anorexia, treatment-associated toxicities, and information and care planning for quality-indicator development. Using search terms and selection criteria, we identified English-language documents from Medline (1997-2007) and Internet-based searches. Based on this evidence, clinician-reviewers proposed process quality indicators. We then used the VA Health Services Research and Development (VA HSR & D) appropriateness methods to compile the ratings of a multidisciplinary, international expert panel of the validity and feasibility of each indicator. The panel judged 92 out of 133 (69%) proposed quality indicators valid and feasible (15 out of 23 pain, 5 out of 6 depression, 8 out of 11 dyspnea, 15 out of 19 nausea and vomiting, 13 out of 26 fatigue and anorexia, 23 out of 32 other treatment-associated toxicities, and 13 out of 16 information and care planning). Of the final indicators, 67 are potentially useful for inpatient and 81 for outpatient evaluation, and 26 address screening, 12 diagnostic evaluation, 20 management, and 21 follow-up. These quality indicators provide evidence-explicit tools for measuring processes critical to ensuring high-quality supportive cancer care. Research is needed to characterize adherence to recommended practices and to evaluate the use of these measures in quality improvement efforts.
KW - Quality of care
KW - cancer
KW - palliative care
KW - supportive care
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U2 - 10.1016/j.jpainsymman.2008.05.018
DO - 10.1016/j.jpainsymman.2008.05.018
M3 - Article
C2 - 19359135
AN - SCOPUS:66149109610
SN - 0885-3924
VL - 37
SP - 943
EP - 964
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 6
ER -