Patient and Provider Concordance on Symptoms During the Oncology Outpatient Clinic Visit

Background: Cancer patients experience multiple symptoms, with specific symptoms varying by cancer type. Problems in communication between patients and health care providers (HCPs) can interfere with effective symptom assessment and management.

Objective: To address gaps in previous research by prospectively examining concordance between HCPs and patients on identifying patients' symptoms by using an identical tool for patients and HCPs at the time of the oncology clinic visit.

Methods: 94 patients completed measures of symptom experience and medical comorbidities before seeing their oncology medical team. HCPs were informed of a patient's participation in the study before seeing the patient in clinic. Immediately after the clinic visit, HCPs completed a symptom survey in which they noted the patient's symptoms.

Results: Patients reported more symptoms than the HCPs endorsed. The highest level of concordance for any symptom fell in the moderate agreement range. Kappa values reflecting concordance between patients and HCPs were not significantly different between the various patient-HCP pairs. No demographic or clinical variables for patients were found to be statistically related to the level of agreement on patients' symptoms.

Limitations: The use of a small convenience sample size drawn from 3 specialty oncology outpatient clinics may limit the generalizability of the results to other types of cancer. The distribution of cancer stage was weighted toward stages III and IV, likely contributing to the number of symptoms.

Conclusions: The level of agreement between HCPs and oncology patients on patient symptoms is weak. Concordance levels were similar, regardless of the type of HCP.