Clinical decision support (CDS) using symptom assessment and management intervention (SAMI) improved management of anxiety, depression, and fatigue, and increased palliative care consults for pain in patients with lung cancer, a study reported at the 2014 Palliative Care in Oncology Symposium in Boston, Massachusetts (Abstract #1).

Researchers at Dana-Farber Cancer Institute and Boston Medical Center in Boston, Massachusetts, chose to investigate CDS as a method to manage patients’ symptoms and trigger referrals to the palliative care at the point of care.

For the study, clinicians and their patients were randomly assigned to usual care or CDS using SAMI. Patients filled out a web-based symptom assessment before each clinic visit, and in the SAMI arm, SAMI provided rapid, individualized recommendations to treat the patients’ anxiety, depression, dyspnea, fatigue, and/or pain to clinicians.

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“We targeted the most common symptoms that occur in patients with lung cancer,” said Mary E. Cooley, PhD, RN, FAAN, of the Dana-Farber Cancer Institute, while presenting the results of the study. Results showed that patients in the SAMI arm were more likely to have their anxiety (OR=1.7; 90% CI, 1.0-3.0), depression (OR=1.6; 90% CI, 1.0-2.5), and fatigue (OR=1.6, 90% CI, 1.1-2.5) managed compared with those that received usual care. 

In addition, Dr. Cooley said that subgroup analyses demonstrated that patients in the SAMI arm also had higher odds of receiving a palliative care consult for pain (OR=3.2; 90% CI, 0.7-13.4) compared with those in the usual care group.