Purpose
Routine screening combined with appropriate management has been recommended to increase the detection and management of distress among cancer patients. However, few centres have implemented screening on a large scale. We propose to describe the QUICATOUCH program of routine screening for pain and distress at Calvary Mater Newcastle.
Methods
Over four years (2007-2011) a paid Screening Assistant assisted oncology outpatients to complete a brief, computerized assessment of their pain and distress prior to their outpatient appointment. A Clinician Alert was generated if patients were over threshold for pain (scoring one or more out of 10) or over threshold for distress (scoring four or more out of 10), and this was printed in time for the consultation with their oncologist. Cancer Care Coordinators have electronic access to screening results and can conduct screening over the phone. A screening module for caregivers was developed.
Results
Preliminary results indicate that over 27,000 occasions of screening were undertaken in four years. The percentage of patients reporting pain and distress above threshold levels decreased from 32% to 12% and 28 % to 9% respectively in that time. Detailed analysis of data from 4755 individual patients screened in the first 24 months indicated that the decreased prevalence was not explained by sample differences in gender, age, clinic type or treatment status. Use of QUICATOUCH has expanded to other locations both within and outside our health service area.
Conclusion
QUICATOUCH is an acceptable model for screening for pain and distress. Pain and distress levels among oncology outpatients at our hospital significantly reduced, consistent with a positive effect of routine screening.