Prevalence of symptoms of cancer patients and Feasibility of Patient Diary Tool (PDT): a prospective, multi-center, pilot study

Objective: To study the symptom epidemiology of cancer patients before admission, in hospital and after discharge; To evaluate the feasibility and effectivity of Patient Diary Tool (PDT). Methods: 17 hospitals were enrolled in this study. Doctors in oncology department gave patients the “Patient Diary Tool (PDT)”, and told them how to fill in. The patients filled in the diaries carefully every day. Meanwhile，the related symptoms of patients before admission, in hospital and after discharge were obtained by the third-party researchers (the investigated symptoms were determined according to NCCN palliative care guidelines and hospice care practice guidelines), and the epidemiology of the above symptoms was studied. The feasibility of Patient Diary Tool was obtained through the satisfaction survey of patients, and the effectivity of Patient Diary Tool was obtained through the satisfaction survey of doctors. Results: Analysis of 152 cases of qualified symptom records: The top ten symptoms of cancer patients when they were admitted to the hospital were fatigue, decreased appetite (the last one week), pain, and weight loss (the last one month), poor sleep, anorexia, chest tightness, shortness of breath, constipation, cough and sputum, and depression; the top ten symptoms in hospitalization were constipation, nausea and vomiting, anorexia, decreased appetite (the last one week), abdominal distension, pain, poor sleep, fatigue and diarrhea. The top ten symptoms after discharge were fatigue, constipation, poor sleep, chest tightness, shortness of breath, pain, cough and sputum, anorexia, sweating, decreased urination, and depression. The prevalence of symptoms on admission for patients with IV stage tumor disease is significantly higher than that of non-IV stage patients. Most of patients (91.4%,139/152) and most doctors (64.4%,98/152)approved of Patient Diary Tool for its feasibility and effectivity. Conclusion: The incidence of related symptoms in patients with stage IV tumor was significantly higher than that in patients with non-stage IV tumor, which should be focused on more attention, monitoring and management. The clinical symptoms of tumor patients will be improved in hospital, but the treatment-related adverse reactions make the symptoms rising again after discharged, which needs more attention and strengthened follow-up and symptom management. The patient diary tool can help the patients to pay attention to all tumor related symptoms and improve the efficiency of ward round, meanwhile the patient diary tool can help not only patients but their family members or care givers to manage the whole process of disease-related symptoms after discharge, which is worthy of further clinical research and promotional application.