Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis
Understanding the symptom burden trajectory for metastatic breast cancer patients can enable the provision of appropriate supportive care for symptom management. The aim of this study was to describe the longitudinal trajectories of symptom burden for metastatic breast cancer patients at the populat...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/28/1/87 |
| _version_ | 1797520708701519872 |
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| author | Suman Budhwani Rahim Moineddin Walter P. Wodchis Camilla Zimmermann Doris Howell |
| author_facet | Suman Budhwani Rahim Moineddin Walter P. Wodchis Camilla Zimmermann Doris Howell |
| author_sort | Suman Budhwani |
| collection | DOAJ |
| description | Understanding the symptom burden trajectory for metastatic breast cancer patients can enable the provision of appropriate supportive care for symptom management. The aim of this study was to describe the longitudinal trajectories of symptom burden for metastatic breast cancer patients at the population-level. A cohort of 995 metastatic breast cancer patients with 16,146 Edmonton Symptom Assessment System (ESAS) assessments was constructed using linked population-level health administrative databases. The patient-reported ESAS total symptom distress score (TSDS) was studied over time using group-based trajectory modeling, and covariate influences on trajectory patterns were examined. Cohort patients experienced symptom burden that could be divided into six distinct trajectories. Patients experiencing a higher baseline TSDS were likely to be classified into trajectory groups with high, uncontrolled TSDS within the study follow-up period (χ<sup>2</sup> (1, <i>N</i> = 995) = 136.25, <i>p</i> < 0.001). Compared to patients classified in the group trajectory with the highest relative TSDS (Group 6), patients classified in the lowest relative TSDS trajectory group (Group 1) were more likely to not have comorbidities (97.34% (for Groups 1–3) vs. 91.82% (for Group 6); <i>p</i> < 0.05), more likely to receive chemotherapy (86.52% vs. 80.50%; <i>p</i> < 0.05), and less likely to receive palliative care (52.81% vs. 79.25%; <i>p</i> < 0.0001). Receiving radiotherapy was a significant predictor of how symptom burden was experienced in all identified groups. Overall, metastatic breast cancer patients follow heterogeneous symptom burden trajectories over time, with some experiencing a higher, uncontrolled symptom burden. Understanding trajectories can assist in establishing risk-stratified care pathways for patients. |
| first_indexed | 2024-03-10T08:00:27Z |
| format | Article |
| id | doaj.art-d26a2a1b11114c31ac0bb0eb52c59eec |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T08:00:27Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-d26a2a1b11114c31ac0bb0eb52c59eec2023-11-22T11:31:42ZengMDPI AGCurrent Oncology1198-00521718-77292021-02-0128187989710.3390/curroncol28010087Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling AnalysisSuman Budhwani0Rahim Moineddin1Walter P. Wodchis2Camilla Zimmermann3Doris Howell4Institute for Health System Solutions and Virtual Care, Women’s College Hospital, Toronto, ON M5S 1B2, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, ON M5G 1V7, CanadaInstitute of Clinical Evaluative Sciences, Toronto, ON M4N 3M5, CanadaPrincess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, CanadaPrincess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, CanadaUnderstanding the symptom burden trajectory for metastatic breast cancer patients can enable the provision of appropriate supportive care for symptom management. The aim of this study was to describe the longitudinal trajectories of symptom burden for metastatic breast cancer patients at the population-level. A cohort of 995 metastatic breast cancer patients with 16,146 Edmonton Symptom Assessment System (ESAS) assessments was constructed using linked population-level health administrative databases. The patient-reported ESAS total symptom distress score (TSDS) was studied over time using group-based trajectory modeling, and covariate influences on trajectory patterns were examined. Cohort patients experienced symptom burden that could be divided into six distinct trajectories. Patients experiencing a higher baseline TSDS were likely to be classified into trajectory groups with high, uncontrolled TSDS within the study follow-up period (χ<sup>2</sup> (1, <i>N</i> = 995) = 136.25, <i>p</i> < 0.001). Compared to patients classified in the group trajectory with the highest relative TSDS (Group 6), patients classified in the lowest relative TSDS trajectory group (Group 1) were more likely to not have comorbidities (97.34% (for Groups 1–3) vs. 91.82% (for Group 6); <i>p</i> < 0.05), more likely to receive chemotherapy (86.52% vs. 80.50%; <i>p</i> < 0.05), and less likely to receive palliative care (52.81% vs. 79.25%; <i>p</i> < 0.0001). Receiving radiotherapy was a significant predictor of how symptom burden was experienced in all identified groups. Overall, metastatic breast cancer patients follow heterogeneous symptom burden trajectories over time, with some experiencing a higher, uncontrolled symptom burden. Understanding trajectories can assist in establishing risk-stratified care pathways for patients.https://www.mdpi.com/1718-7729/28/1/87breast neoplasmsneoplasm metastasispalliative caresymptom assessmentsyndromecohort studies |
| spellingShingle | Suman Budhwani Rahim Moineddin Walter P. Wodchis Camilla Zimmermann Doris Howell Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis Current Oncology breast neoplasms neoplasm metastasis palliative care symptom assessment syndrome cohort studies |
| title | Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis |
| title_full | Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis |
| title_fullStr | Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis |
| title_full_unstemmed | Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis |
| title_short | Longitudinal Symptom Burden Trajectories in a Population-Based Cohort of Women with Metastatic Breast Cancer: A Group-Based Trajectory Modeling Analysis |
| title_sort | longitudinal symptom burden trajectories in a population based cohort of women with metastatic breast cancer a group based trajectory modeling analysis |
| topic | breast neoplasms neoplasm metastasis palliative care symptom assessment syndrome cohort studies |
| url | https://www.mdpi.com/1718-7729/28/1/87 |
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