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Personalized goal for insomnia and clinical response in advanced cancer patients
- Source :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 28(3)
- Publication Year :
- 2019
-
Abstract
- Aim: The aim of this study was to assess the Personalized Insomnia Intensity Goal (PIIG), the achievement of Personalized Goal Response (PGR), and Patient Global Impression (PGI) after a comprehensive symptom management. Patients and methods: Advanced cancer patients admitted to palliative care units rated pain and symptoms intensity and their PIIG by using the Edmonton Symptom Assessment Score (ESAS) (T0). In patients with significant levels of insomnia, the achievement of target expected (PIIG) was measured (patient goal response, PIGR), as well the patient global impression (PGI), by the minimal clinically important difference (MCID), after a comprehensive symptom management (T7). Results: Three hundred ninety-seven patients with a level of insomnia of ≥ 3 on ESAS were analyzed in this study. The mean values of PIIG at T0 and T7 were 1.2 (SD 1.5) and 0.9 (SD 1.4), respectively. Most patients (n = 406, 89.8%) indicated a PIIG of ≤ 3 as a target at T0. Such target was significantly lower at T7 (p = < 0.0005). PGI, expressed as MCID, was perceived with a mean decrease in insomnia intensity of − 2.3. In a minority of patients (n = 26; 5.8%) insomnia worsened, with a MCID of 0.50 (SD 2.8). Higher insomnia intensity at T0 and lower insomnia intensity at T7 were independently related to PGI. PIGR was achieved in 87.9% of patients. PIGR was associated with PIIG at T0, and inversely associated to insomnia intensity at T0 and T7, and PIIG at T7. Conclusion: PGIR and PGI seem to be relevant for evaluating the effects of a comprehensive management of insomnia, suggesting therapeutic decisions according to PIIG. Some factors influencing the individual target and clinical response have been detected.
- Subjects :
- Adult
Male
medicine.medical_specialty
Palliative care
Insomnia
Decision Making
Pain
Symptom assessment
Global impression of change
03 medical and health sciences
0302 clinical medicine
Internal medicine
Advanced cancer
Neoplasms
Sleep Initiation and Maintenance Disorders
medicine
Humans
Pain Management
In patient
030212 general & internal medicine
Aged
Aged, 80 and over
Symptom management
business.industry
Minimal clinically important difference
Palliative Care
Middle Aged
Intensity (physics)
Hospitalization
Oncology
030220 oncology & carcinogenesis
Personalized symptom goal
Female
medicine.symptom
Symptom Assessment
business
Goals
Subjects
Details
- ISSN :
- 14337339
- Volume :
- 28
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
- Accession number :
- edsair.doi.dedup.....598b42efd1574cb0561ddac4d3de4df8