Oncologists' Recognition of Supportive Care Needs and Symptoms of Their Patients in a Breast Cancer Outpatient Consultation

Abstract

The purpose of this study was to investigate the accuracy of oncologists' recognition of their patients' supportive care needs and symptoms in breast cancer outpatient consultation in Japan. The participants included a sample of randomly selected outpatients with breast cancer and two oncologists. The patients responded to validated self-administered questionnaires to assess their supportive care needs and symptoms. The oncologists responded to a questionnaire in which they indicated their perception of level of the same set of needs or symptoms following consultation. The two data sets were compared statistically. Complete data sets were available for 408 patients. Low negative predictive values for the psychological (30%) and information domain (30%) indicated that the patients often have psychological and information needs that the oncologists do not appropriately recognize. The sensitivity and specificity of the physicians' assessment for all physical symptoms except pain were 85%, respectively, indicating that the physicians could not detect, but could rule out the possibility of a patient experiencing physical symptoms. Borderline/clinical depression and anxiety were the only two symptoms that the oncologists reported more frequently than the patients did. As a result, the specificity of the physicians' assessment for the detection of borderline/clinical depression and anxiety was relatively low (74 and 27%). Oncologists' recognition may not accurately reflect their patients' supportive care needs and symptoms in usual care. Incorporation of a standard assessment system for supportive care needs and symptoms in clinical practice must heighten the oncologists' awareness of their patients' these problems.