Original Article

Edmonton Symptom Assessment System for Outpatient Symptom Monitoring of Sickle Cell Disease

Authors: Gabriel Lopez, MD, Darla K. Liles, MD, Charles L. Knupp, MD


Objectives: Although the extension of palliative care methodology to sickle cell disease (SCD) care has been proposed, there is no current standard for symptom assessment. Our goal was to assess the feasibility of integrating the Edmonton Symptom Assessment System (ESAS) into the outpatient management of SCD.

Methods: Seventy-five adult patients presenting for outpatient visits at a comprehensive SCD center were enrolled. Patients completed the ESAS (self-report of 10 symptoms during the last 24 hours) and a survey regarding their opinion of the ESAS at enrollment and follow-up.

Results: Pain ( P = 0.0272) was the only symptom score that changed significantly between the initial and follow-up visits. In patients with a self-reported pain crisis, pain ( P < 0.0001), fatigue ( P = 0.0025), depression ( P = 0.0458), nausea ( P = 0.0384), and symptom distress scores ( P = 0.0019) were significantly higher than for patients without a pain crisis. On the initial visit, 92% of all patients agreed or strongly agreed that the ESAS was easy to complete; 83% were satisfied or very satisfied with the ESAS as a way to report symptoms.

Conclusions: Our data suggest that the ESAS is well received and can be successfully included as part of the longitudinal symptom management strategy for SCD.

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