ANALYSIS OF COMMON SYMPTOMS USING THE EDMONTON SYMPTOM ASSESSMENT SYSTEM IN TERMINALLY ILL CANCER PATIENTS RECEIVING PALLIATIVE CARE AT A TERTIARY CARE CENTER OF NEPAL

Abstract

Background: The Edmonton Symptom Assessment System (ESAS) is a reliable tool to assess the severity of Symptom over time. It evaluates nine symptoms commonly experienced by patients with cancer and other advanced illness. The aim of this study is to find the prevalent symptoms, intensity and prognostic significance of common symptoms in cancer patients. 

Methods: This prospective cross-sectional study enrolled 110 patients with terminal cancer receiving palliative care admitted at clinical oncology department of Bir Hospital. Patients providing informed written consent were advised to complete ESAS questionnaire within 24 hours of hospital admission. Data entry and analysis done in Microsoft Excel Version 2013. Frequency distributions, percentages, means, and standard deviations of various symptoms were analyzed. Scatter diagram was prepared to evaluate the time trend of all nine ESAS items toward death.

Results: One hundred ten patients (mean age 53.76 ± 10.63 years, 70 female and 40 male) completed ESAS score questionnaire. The most common symptom experienced was poor well-being 97(88.18%), followed by tiredness 91(82.72%) and lack of appetite 88(80%). Most severe symptoms were poor well-being with a mean score of 5.27 ± 3.08, followed by tiredness (3.55 ± 2.46), pain (3.24 ± 2.61) and lack of appetite (3.15 ± 2.53) and all the symptoms tend to deteriorate towards end of life.

Conclusions: Edmonton Symptom Assessment System (ESAS) can be used easily to assess common symptoms and their intensity in cancer patients which help to provide specific symptom directed treatment and care.