Patient factors associated with discrepancies between patient-reported and clinician-documented peripheral neuropathy in women with breast cancer receiving paclitaxel: A pilot study

Teresa M Salgado; Jin Liu; Holly L Reed; Caroline S Quinn; Jillian G Syverson; Jennifer Le-Rademacher; Camden L Lopez; Andreas S Beutler; Charles L Loprinzi; Kiran Vangipuram; Ellen M Lavoie Smith; N Lynn Henry; Karen B Farris; Daniel L Hertz

doi:10.1016/j.breast.2020.02.011

Patient factors associated with discrepancies between patient-reported and clinician-documented peripheral neuropathy in women with breast cancer receiving paclitaxel: A pilot study

Breast. 2020 Jun:51:21-28. doi: 10.1016/j.breast.2020.02.011. Epub 2020 Mar 3.

Authors

Affiliations

¹ Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, 410 N. 12th Street PO Box 98053, 23298, Richmond, VA, USA. Electronic address: tmsalgado@vcu.edu.
² Department of Biostatistics, School of Medicine, Virginia Commonwealth University, 830 East Main Street, 7th Floor, 23298, Richmond, VA, USA.
³ Department of Pharmaceutical and Nutrition Care, Nebraska Medicine, 981090 Nebraska Medical Center, 68198-1090, Omaha, NE, USA.
⁴ Department of Pharmacy, University of Wisconsin Health, 600 Highland Avenue, 53792, Madison, WI, USA.
⁵ Meijer Pharmacy, 3145 Ann Arbor-Saline Rd, 48103, Ann Arbor, MI, USA.
⁶ Alliance Statistics and Data Center, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA; Mayo Clinic Cancer Center, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA.
⁷ Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA.
⁸ Mayo Clinic Cancer Center, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA; Department of Oncology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA.
⁹ Takeda Pharmaceuticals Inc., 40 Landsdowne St, 02139, Cambridge, MA, USA.
¹⁰ Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 426 N Ingalls St, 48104, Ann Arbor, MI, USA.
¹¹ Rogel Cancer Center, University of Michigan, 1500 E Medical Center Dr, 48109, Ann Arbor, MI, USA.
¹² Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, 428 Church St, 48109, Ann Arbor, MI, USA.

Abstract

Purpose: Discrepancies between clinicians' assessment of chemotherapy-induced peripheral neuropathy (CIPN) and patient-reported outcomes (PRO) have been described, though the underlying reasons are unknown. Our objective was to identify potential patient-specific factors associated with under-describing of CIPN to clinicians in women with non-metastatic breast cancer treated with paclitaxel.

Methods: Patients enrolled in an observational study (n = 60) completed weekly CIPN PRO using the EORTC CIPN20. Clinician-documented CIPN using the NCI CTCAE were abstracted from the electronic medical record and paired with CIPN20 data at weeks 7 and 10. Patients were classified as under-describers if their CIPN20 was above the 80th percentile of the CIPN20 distribution for that CTCAE grade from an independent clinical trial (N08CA). Demographics, Assessment of Survivor Concerns (ASC), Trust in Oncologist Scale (TiOS), and health literacy assessment were collected post-treatment via survey. Repeated measures cumulative logistic regression models were used to identify factors associated with under-describing CIPN.

Results: Forty-two women completed the survey (response rate 70%). Three and 9 patients were categorized as under-describers at weeks 7 and 10, respectively. Women who were not working (OR = 9.00, 95%CI 1.06-76.15), had lower income (OR = 7.04, 95%CI 1.5-32.99), and displayed higher trust in their oncologist's competence (OR = 1.29, 95%CI 1.03-1.62 for a 0.1-unit increase in score) were more likely to under-describe CIPN symptoms.

Conclusions: This preliminary study identified non-working status, low income and trust in oncologist's competence as potential factors influencing under-description of CIPN to the clinical team. Further work is needed to clarify these relationships and test additional factors.

Keywords: Breast cancer; Chemotherapy-induced peripheral neuropathy; Patient reported outcome measures; Taxoids.

Publication types

Observational Study

MeSH terms

Adult
Aged
Antineoplastic Agents / adverse effects*
Breast Neoplasms / drug therapy*
Breast Neoplasms / psychology*
Electronic Health Records / statistics & numerical data
Female
Health Literacy / statistics & numerical data
Humans
Middle Aged
Paclitaxel / adverse effects*
Patient Reported Outcome Measures*
Peripheral Nervous System Diseases / chemically induced*
Pilot Projects
Socioeconomic Factors
Trust / psychology

Substances

Antineoplastic Agents
Paclitaxel

Abstract

Publication types

MeSH terms

Substances

Grants and funding