Systematic supportive care screening using the NCCN Distress Thermometer and Problem Checklist (DT) commenced in Victoria in 2010 to identify and manage the supportive care needs of cancer patients. In 2013 a standardised state-wide review of the screened population was agreed.
Monitor the distress, needs and outcomes from supportive care screens in Victoria and compare nationally and internationally.
Use the findings at a local and state level to address service gaps and plan services to address identified needs.
A state-wide retrospective audit was undertaken on a sample of the 2013 screened cancer population. All items on the screening tool were collected and additional information about the patient, their cancer, treatment and action taken. Distress scores were categorised into low (<4), medium (4-8) and high (8-10). Analysis by region, tumour type, screening location, and treatment stage were compared to various scales to explore themes and service gaps to guide future service improvement programs.
Over 2000 individual supportive care screens were audited. The breakdown of distress scores by category was consistent across the state and with international findings. Tumour types most commonly screened include: Breast, colorectal, haematological, lung and upper gastro-intestinal. Of these, distress scores recorded demonstrated that 14% of the breast and lung tumour streams scored 8 or above. The median number of problems identified per person was 5. The domains of emotional; worry (50%), nervousness (45%), sadness (36%), fears (34%), depression (20%), and physical; fatigue (45%), sleep (39%), pain (29%), eating (22%), memory (21%) were most commonly identified. Further data analysis into relationships between disease, treatment, problems and distress is underway.
Standardised detailed data collection of supportive care screening does provide valuable information about supportive care needs of the cancer population and can be used to guide service improvement to address identified need.