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
Affiliations
Teresa M. Salgado
Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University, 410 N. 12th Street PO Box 98053, 23298, Richmond, VA, USA; Corresponding author. Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, 410 N. 12th Street, PO Box 980533, VA, 23298, USA.
Jin Liu
Department of Biostatistics, School of Medicine, Virginia Commonwealth University, 830 East Main Street, 7th Floor, 23298, Richmond, VA, USA
Holly L. Reed
Department of Pharmaceutical and Nutrition Care, Nebraska Medicine, 981090 Nebraska Medical Center, 68198–1090, Omaha, NE, USA
Caroline S. Quinn
Department of Pharmacy, University of Wisconsin Health, 600 Highland Avenue, 53792, Madison, WI, USA
Jillian G. Syverson
Meijer Pharmacy, 3145 Ann Arbor-Saline Rd, 48103, Ann Arbor, MI, USA
Jennifer Le-Rademacher
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
Camden L. Lopez
Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA
Andreas S. Beutler
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
Charles L. Loprinzi
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
Kiran Vangipuram
Takeda Pharmaceuticals Inc., 40 Landsdowne St, 02139, Cambridge, MA, USA
Ellen M. Lavoie Smith
Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 426 N Ingalls St, 48104, Ann Arbor, MI, USA
N Lynn Henry
Rogel Cancer Center, University of Michigan, 1500 E Medical Center Dr, 48109, Ann Arbor, MI, USA
Karen B. Farris
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, 428 Church St, 48109, Ann Arbor, MI, USA
Daniel L. Hertz
Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, 428 Church St, 48109, Ann Arbor, MI, USA
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.
