Skip to main content
Erschienen in: Wiener klinisches Magazin 3/2017

01.06.2017 | Palliativmedizin

Computergestütztes Screening auf Palliativbedarf bei onkologischen Patienten

Projekt zur Verbesserung der Beratung und Unterstützung von Krebspatienten und ihren Angehörigen (BUKA)

verfasst von: Dr. Matthias Lukasczik, Dipl.-Psych. Bettina Seekatz, Sandra Radina, Annalena Häckel, Prof. Dr. Silke Neuderth, Prof. Dr. Birgitt van Oorschot

Erschienen in: Wiener klinisches Magazin | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Zur Identifizierung onkologischer Patienten mit palliativmedizinischem Versorgungsbedarf werden zunehmend auch Screenings eingesetzt. Diese sollen die relativ aufwandsarme Erfassung von Symptomen, Belastungsfaktoren sowie Informations- und Versorgungsbedürfnissen ermöglichen. Auf dieser Basis kann dann eine gezielte Zuweisung zu weitergehenden diagnostischen und therapeutischen Maßnahmen erfolgen.

Ziel und Methode

PC-gestützte Screenings finden zunehmend Anwendung, sind in Deutschland bislang jedoch noch nicht erprobt worden. Hier setzt das Projekt BUKA (Beratung und Unterstützung von Krebspatienten und ihren Angehörigen) an, in dem derzeit untersucht wird, ob der Einsatz eines tabletgestützten Screenings auf palliativmedizinischen und psychosozialen Versorgungsbedarf mit Veränderungen in klinischen Qualitätsindikatoren (EoLQ-Indikatoren) einhergeht. Es werden palliative Tumorpatienten der Entitäten Hautkrebs, Lungenkrebs, gastrointestinale Tumoren und primäre Hirntumoren einbezogen. Die Datenerhebung erfolgt zu zwei Messzeitpunkten (Screening, 8-Wochen-Katamnese). Erhoben werden unter anderem körperliche Beschwerden, psychosoziale Symptome sowie Informations- und Unterstützungsbedarf. Eine Pilotstudie lässt auf ein hohes Maß an Akzeptanz seitens der befragten Patienten schließen.
Literatur
2.
Zurück zum Zitat Greer JA, Pirl WF, Jackson VA et al (2012) Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. J Clin Oncol 30:394–400CrossRefPubMed Greer JA, Pirl WF, Jackson VA et al (2012) Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. J Clin Oncol 30:394–400CrossRefPubMed
3.
Zurück zum Zitat Temel JS, Greer JA, Muzikansky A et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363(8):733–742CrossRefPubMed Temel JS, Greer JA, Muzikansky A et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363(8):733–742CrossRefPubMed
4.
Zurück zum Zitat Ferris FD, Bruera E, Cherny N et al (2009) Palliative cancer care a decade later: accomplishments, the need, next steps – from the American Society of Clinical Oncology. J Clin Oncol 27(18):3052–3058. doi:10.1200/JCO.2008.20.1558CrossRefPubMed Ferris FD, Bruera E, Cherny N et al (2009) Palliative cancer care a decade later: accomplishments, the need, next steps – from the American Society of Clinical Oncology. J Clin Oncol 27(18):3052–3058. doi:10.1200/JCO.2008.20.1558CrossRefPubMed
5.
Zurück zum Zitat Smith TJ, Temin S, Alesi ER et al (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol 30(8):880–887. doi:10.1200/JCO.2011.38.5161CrossRefPubMed Smith TJ, Temin S, Alesi ER et al (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol 30(8):880–887. doi:10.1200/JCO.2011.38.5161CrossRefPubMed
6.
Zurück zum Zitat Kleeberg U, Voltz R (2011) Individuelle Behandlung von Patienten mit fortgeschrittenem Krebs. InFoOnkologie 14(5):52–54 Kleeberg U, Voltz R (2011) Individuelle Behandlung von Patienten mit fortgeschrittenem Krebs. InFoOnkologie 14(5):52–54
9.
Zurück zum Zitat Braiteh F, El Osta B, Palmer JL et al (2007) Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center. J Palliat Med 10(4):948–955. doi:10.1089/jpm.2006.0257CrossRefPubMed Braiteh F, El Osta B, Palmer JL et al (2007) Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center. J Palliat Med 10(4):948–955. doi:10.1089/jpm.2006.0257CrossRefPubMed
10.
Zurück zum Zitat Bruera E, Yennurajalingam S (2012) Palliative care in advanced cancer patients: how and when? Oncologist 17(2):267–273. doi:10.1634/theoncologist.2011-0219CrossRefPubMedPubMedCentral Bruera E, Yennurajalingam S (2012) Palliative care in advanced cancer patients: how and when? Oncologist 17(2):267–273. doi:10.1634/theoncologist.2011-0219CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Andersen BL, DeRubeis RJ, Berman BS et al (2014) Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol 32(15):1605–1619CrossRefPubMedPubMedCentral Andersen BL, DeRubeis RJ, Berman BS et al (2014) Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol 32(15):1605–1619CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Carlson LE, Waller A, Mitchell AJ (2012) Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol 30(11):1160–1177CrossRefPubMed Carlson LE, Waller A, Mitchell AJ (2012) Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol 30(11):1160–1177CrossRefPubMed
13.
Zurück zum Zitat Donovan KA, Grassi L, McGinty HL et al (2014) Validation of the distress thermometer worldwide: state of the science. Psychooncology 23(3):241–250CrossRefPubMed Donovan KA, Grassi L, McGinty HL et al (2014) Validation of the distress thermometer worldwide: state of the science. Psychooncology 23(3):241–250CrossRefPubMed
14.
Zurück zum Zitat Meijer A, Roseman M, Delisle VC et al (2013) Effects of screening for psychological distress on patient outcomes in cancer: a systematic review. J Psychosom Res 75(1):1–17CrossRefPubMed Meijer A, Roseman M, Delisle VC et al (2013) Effects of screening for psychological distress on patient outcomes in cancer: a systematic review. J Psychosom Res 75(1):1–17CrossRefPubMed
15.
Zurück zum Zitat Mitchell AJ (2013) Screening for cancer-related distress: when is implementation successful and when is it unsuccessful? Acta Oncol 52(2):216–224CrossRefPubMed Mitchell AJ (2013) Screening for cancer-related distress: when is implementation successful and when is it unsuccessful? Acta Oncol 52(2):216–224CrossRefPubMed
16.
Zurück zum Zitat Mitchell AJ, Meader N, Davies E et al (2012) Meta-analysis of screening and case finding tools for depression in cancer: evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group. J Affect Disord 140(2):149–160. doi:10.1016/j.jad.2011.12.043CrossRefPubMed Mitchell AJ, Meader N, Davies E et al (2012) Meta-analysis of screening and case finding tools for depression in cancer: evidence based recommendations for clinical practice on behalf of the Depression in Cancer Care consensus group. J Affect Disord 140(2):149–160. doi:10.1016/j.jad.2011.12.043CrossRefPubMed
17.
Zurück zum Zitat Watanabe SM, Nekolaichuk CL, Beaumont C (2012) The Edmonton Symptom Assessment System, a proposed tool for distress screening in cancer patients: development and refinement. Psychooncology 21(9):977–985CrossRefPubMed Watanabe SM, Nekolaichuk CL, Beaumont C (2012) The Edmonton Symptom Assessment System, a proposed tool for distress screening in cancer patients: development and refinement. Psychooncology 21(9):977–985CrossRefPubMed
19.
Zurück zum Zitat Mehnert A (2013) Psychoonkologische Diagnostik. In: Schulz-Kindermann F (Hrsg) Psychoonkologie – Grundlagen und psychotherapeutische Praxis. Beltz, Weinheim, S 175–187 Mehnert A (2013) Psychoonkologische Diagnostik. In: Schulz-Kindermann F (Hrsg) Psychoonkologie – Grundlagen und psychotherapeutische Praxis. Beltz, Weinheim, S 175–187
20.
Zurück zum Zitat Mitchell AJ, Vahabzadeh A, Magruder K (2011) Screening for distress and depression in cancer settings: 10 lessons from 40 years of primary-care research. Psychooncology 20(6):572–584CrossRefPubMed Mitchell AJ, Vahabzadeh A, Magruder K (2011) Screening for distress and depression in cancer settings: 10 lessons from 40 years of primary-care research. Psychooncology 20(6):572–584CrossRefPubMed
21.
Zurück zum Zitat Pirl WF, Fann JR, Greer JA et al (2014) Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer 120(19):2946–2954. doi:10.1002/cncr.28750CrossRefPubMed Pirl WF, Fann JR, Greer JA et al (2014) Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer 120(19):2946–2954. doi:10.1002/cncr.28750CrossRefPubMed
22.
Zurück zum Zitat Oorschot B van, Jentschke E, Heussner P et al (2014) Instrumente zur Erfassung psychosozialer Belastungen, Ressourcen und körperlicher Symptome bei Krebs. Forum DKG 29:131–133 Oorschot B van, Jentschke E, Heussner P et al (2014) Instrumente zur Erfassung psychosozialer Belastungen, Ressourcen und körperlicher Symptome bei Krebs. Forum DKG 29:131–133
23.
Zurück zum Zitat Abernethy AP, Wheeler JL, Currow DC (2010) Utility and use of palliative care screening tools in routine oncology practice. Cancer J 16(5):444–460. doi:10.1097/PPO.0b013e3181f45df0CrossRefPubMed Abernethy AP, Wheeler JL, Currow DC (2010) Utility and use of palliative care screening tools in routine oncology practice. Cancer J 16(5):444–460. doi:10.1097/PPO.0b013e3181f45df0CrossRefPubMed
24.
Zurück zum Zitat Glare PA, Chow K (2014) Validation of a simple screening tool for identifying unmet palliative care needs in patients with cancer. J Oncol Pract. doi:10.1200/JOP.2014.001487 Glare PA, Chow K (2014) Validation of a simple screening tool for identifying unmet palliative care needs in patients with cancer. J Oncol Pract. doi:10.1200/JOP.2014.001487
25.
Zurück zum Zitat Cobb M, Dowrick C, Lloyd-Williams M (2012) What can we learn about the spiritual needs of palliative care patients from the research literature? J Pain Symptom Manage 43(6):1105–1119. doi:10.1016/j.jpainsymman.2011.06.017CrossRefPubMed Cobb M, Dowrick C, Lloyd-Williams M (2012) What can we learn about the spiritual needs of palliative care patients from the research literature? J Pain Symptom Manage 43(6):1105–1119. doi:10.1016/j.jpainsymman.2011.06.017CrossRefPubMed
26.
Zurück zum Zitat Krause S, Rydall A, Hales S et al (2015) Initial validation of the Death and Dying Distress Scale for the assessment of death anxiety in patients with advanced cancer. J Pain Symptom Manage 49(1):126–134CrossRefPubMed Krause S, Rydall A, Hales S et al (2015) Initial validation of the Death and Dying Distress Scale for the assessment of death anxiety in patients with advanced cancer. J Pain Symptom Manage 49(1):126–134CrossRefPubMed
27.
Zurück zum Zitat Glare PA, Semple D, Stabler SM et al (2011) Palliative care in the outpatient oncology setting: evaluation of a practical set of referral criteria. J Oncol Pract 7(6):366–370. doi:10.1200/JOP.2011.000367CrossRefPubMedPubMedCentral Glare PA, Semple D, Stabler SM et al (2011) Palliative care in the outpatient oncology setting: evaluation of a practical set of referral criteria. J Oncol Pract 7(6):366–370. doi:10.1200/JOP.2011.000367CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Morita T, Fujimoto K, Namba M et al (2008) Palliative care needs of cancer outpatients receiving chemotherapy: an audit of a clinical screening project. Support Care Cancer 16(1):101–107. doi:10.1007/s00520-007-0271-6CrossRefPubMed Morita T, Fujimoto K, Namba M et al (2008) Palliative care needs of cancer outpatients receiving chemotherapy: an audit of a clinical screening project. Support Care Cancer 16(1):101–107. doi:10.1007/s00520-007-0271-6CrossRefPubMed
29.
Zurück zum Zitat Johnsen AT, Damkier A, Vejlgaard TB et al (2013) A randomised, multicentre clinical trial of specialised palliative care plus standard treatment versus standard treatment alone for cancer patients with palliative care needs: the Danish palliative care trial (DanPaCT) protocol. BMC Palliat Care 12(1):37. doi:10.1186/1472-684X-12-37CrossRefPubMedPubMedCentral Johnsen AT, Damkier A, Vejlgaard TB et al (2013) A randomised, multicentre clinical trial of specialised palliative care plus standard treatment versus standard treatment alone for cancer patients with palliative care needs: the Danish palliative care trial (DanPaCT) protocol. BMC Palliat Care 12(1):37. doi:10.1186/1472-684X-12-37CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Aktas A, Hullihen B, Shrotriya S et al (2015) Connected health: cancer symptom and quality-of-life assessment using a tablet computer: a pilot study. Am J Hosp Palliat Med 32(2):189–197. doi:10.1177/1049909113510963CrossRef Aktas A, Hullihen B, Shrotriya S et al (2015) Connected health: cancer symptom and quality-of-life assessment using a tablet computer: a pilot study. Am J Hosp Palliat Med 32(2):189–197. doi:10.1177/1049909113510963CrossRef
31.
Zurück zum Zitat Hjermstad MJ, Lie HC, Caraceni A et al (2012) Computer-based symptom assessment is feasible in patients with advanced cancer: results from an international multicenter study, the EPCRC-CSA. J Pain Symptom Manage 44(5):639–654. doi:10.1016/j.jpainsymman.2011.10.025CrossRefPubMed Hjermstad MJ, Lie HC, Caraceni A et al (2012) Computer-based symptom assessment is feasible in patients with advanced cancer: results from an international multicenter study, the EPCRC-CSA. J Pain Symptom Manage 44(5):639–654. doi:10.1016/j.jpainsymman.2011.10.025CrossRefPubMed
32.
Zurück zum Zitat Stukenborg GJ, Blackhall L, Harrison J et al (2014) Cancer patient-reported outcomes assessment using wireless touch screen tablet computers. Qual Life Res 23(5):1603–1607. doi:10.1007/s11136-013-0595-2CrossRefPubMed Stukenborg GJ, Blackhall L, Harrison J et al (2014) Cancer patient-reported outcomes assessment using wireless touch screen tablet computers. Qual Life Res 23(5):1603–1607. doi:10.1007/s11136-013-0595-2CrossRefPubMed
33.
Zurück zum Zitat Hannon B, Swami N, Pope A et al (2015) The oncology palliative care clinic at the Princess Margaret Cancer Centre: an early intervention model for patients with advanced cancer. Support Care Cancer 23(4):1073–1080. doi:10.1007/s00520-014-2460-4CrossRefPubMed Hannon B, Swami N, Pope A et al (2015) The oncology palliative care clinic at the Princess Margaret Cancer Centre: an early intervention model for patients with advanced cancer. Support Care Cancer 23(4):1073–1080. doi:10.1007/s00520-014-2460-4CrossRefPubMed
34.
Zurück zum Zitat Zimmermann C, Swami N, Krzyzanowska M et al (2014) Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet 383(9930):1721–1730. doi:10.1016/S0140-6736(13)62416-2CrossRefPubMed Zimmermann C, Swami N, Krzyzanowska M et al (2014) Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet 383(9930):1721–1730. doi:10.1016/S0140-6736(13)62416-2CrossRefPubMed
35.
Zurück zum Zitat Kroenke K, Spitzer RL, Williams JB et al (2010) The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry 32(4):345–359CrossRefPubMed Kroenke K, Spitzer RL, Williams JB et al (2010) The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry 32(4):345–359CrossRefPubMed
36.
Zurück zum Zitat Spitzer RL, Kroenke K, Williams JB et al (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097CrossRefPubMed Spitzer RL, Kroenke K, Williams JB et al (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097CrossRefPubMed
37.
Zurück zum Zitat Wright P, Smith A, Roberts K et al (2007) Screening for social difficulties in cancer patients: clinical utility of the Social Difficulties Inventory. Br J Cancer 97(8):1063–1070CrossRefPubMedPubMedCentral Wright P, Smith A, Roberts K et al (2007) Screening for social difficulties in cancer patients: clinical utility of the Social Difficulties Inventory. Br J Cancer 97(8):1063–1070CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Earle CC, Landrum MB, Souza JM et al (2008) Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J Clin Oncol 26(23):3860–3866. doi:10.1200/JCO.2007.15.8253CrossRefPubMedPubMedCentral Earle CC, Landrum MB, Souza JM et al (2008) Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J Clin Oncol 26(23):3860–3866. doi:10.1200/JCO.2007.15.8253CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Stiel S, Matthes ME, Bertram L et al (2010) Validierung der neuen Fassung des Minimalen Dokumentationssystems (MIDOS2) für Patienten in der Palliativmedizin. Schmerz 24(6):596–604. doi:10.1007/s00482-010-0972-5CrossRefPubMed Stiel S, Matthes ME, Bertram L et al (2010) Validierung der neuen Fassung des Minimalen Dokumentationssystems (MIDOS2) für Patienten in der Palliativmedizin. Schmerz 24(6):596–604. doi:10.1007/s00482-010-0972-5CrossRefPubMed
40.
Zurück zum Zitat Groenvold M, Petersen MA, Aaronson NK et al (2006) The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care. Eur J Cancer 42(1):55–64. doi:10.1016/j.ejca.2005.06.022CrossRefPubMed Groenvold M, Petersen MA, Aaronson NK et al (2006) The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care. Eur J Cancer 42(1):55–64. doi:10.1016/j.ejca.2005.06.022CrossRefPubMed
41.
Zurück zum Zitat Mehnert A, Müller D, Lehmann C et al (2006) Die deutsche Version des NCCN Distress-Thermometers. Z Psychiatr Psychol Psychother 54(3):213–223. doi:10.1024/1661-4747.54.3.213 Mehnert A, Müller D, Lehmann C et al (2006) Die deutsche Version des NCCN Distress-Thermometers. Z Psychiatr Psychol Psychother 54(3):213–223. doi:10.1024/1661-4747.54.3.213
42.
Zurück zum Zitat Kondrup J, Hoejgaard Rasmussen H, Hamberg O et al (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22(3):321–336. doi:10.1016/S0261-5614(02)00214-5CrossRefPubMed Kondrup J, Hoejgaard Rasmussen H, Hamberg O et al (2003) Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 22(3):321–336. doi:10.1016/S0261-5614(02)00214-5CrossRefPubMed
43.
Zurück zum Zitat Canadian Partnership Against Cancer (cpac), Cancer Action Journey Group (2009) Guide to implementing screening for distress, the 6th vital sign: moving towards person-centered care: part a background, recommendations and implementation, Toronto Canadian Partnership Against Cancer (cpac), Cancer Action Journey Group (2009) Guide to implementing screening for distress, the 6th vital sign: moving towards person-centered care: part a background, recommendations and implementation, Toronto
Metadaten
Titel
Computergestütztes Screening auf Palliativbedarf bei onkologischen Patienten
Projekt zur Verbesserung der Beratung und Unterstützung von Krebspatienten und ihren Angehörigen (BUKA)
verfasst von
Dr. Matthias Lukasczik
Dipl.-Psych. Bettina Seekatz
Sandra Radina
Annalena Häckel
Prof. Dr. Silke Neuderth
Prof. Dr. Birgitt van Oorschot
Publikationsdatum
01.06.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 3/2017
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-016-0145-y

Weitere Artikel der Ausgabe 3/2017

Wiener klinisches Magazin 3/2017 Zur Ausgabe

Panorama

Panorama