May 24, 2011
Cancer patients may visit emergency departments when they experience medical problems, but little information is available about the frequency of or reasons for those visits.

Annah Wyss, MPH

Annah Wyss, MPH

A first-ever study of emergency room use by oncology patients in North Carolina was published in the May 23, 2011 online issue of the Journal of Clinical Oncology. Authors, including Annah Wyss, MPH, epidemiology doctoral student at UNC Gillings School of Global Public Health, hope the study can help them target clinical problems to improve delivery of quality cancer care and minimize emergency room visits.

“While some cancer patients develop acute problems that do require a visit to the emergency department, some visits might be avoided with better symptom management,” said Deborah Mayer, PhD, RN, associate professor in the UNC School of Nursing and lead author of the study. Mayer is also a member of UNC Lineberger Comprehensive Cancer Center.

The UNC team used a statewide database to collect information on more than 35,000 emergency department (ED) visits. They learned that the top three problems that brought patients to the ED were related to pain, respiratory distress and gastrointestinal issues (mostly nausea and vomiting).

Mayer thinks some of these problems, such as nausea and vomiting, could be managed by the patient and cancer doctors and nurses. Reasons for a problem need to be explored, she suggests. Did the patient not get a prescription? Was the patient able to fill the prescription and take the medication? If it wasn’t working, did they call their doctor or nurse? Mayer concludes by saying that ‘while we have made great strides in cancer care, this study shows we still have room for improvement.”

Among other people visiting the emergency department, about 15 percent are admitted to the hospital. More than 63 percent of cancer patients were admitted.

Debbie Travers, PhD, RN, assistant professor in the UNC School of Nursing and study co-author, believes that “the study validates the need for emergency department nurses to play an active role in the care and management of acute problems faced by cancer patients.” She said that the study identified additional areas for research, including management of acute symptoms for targeted populations, especially patients with lung cancer.

UNC authors in addition to Mayer, Travers and Wyss are Ashley Leake, RN-BC, MSN (School of Nursing) and Anna Waller, ScD (School of Medicine). The research was funded by the North Carolina Translational and Clinical Sciences (NC TraCS) Institute at The University of North Carolina at Chapel Hill, one of 55 medical research institutions working together as a national consortium to improve the way biomedical research is conducted across the country. The consortium is funded through the National Institutes of Health Clinical and Translational Science Awards (CTSA).

 

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.

 

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