750 / 1082
S734
ESTRO 36 2017
_______________________________________________________________________________________________
not significantly associated with the cumulative incidence
of an adverse event within the studied population.
Conclusion
The clinical applicability of the SINS as a tool to assess
spinal instability seems limited.
EP-1386 Mobile health technologies for severely-ill and
palliative care patients
G. Theile
1
, V. Klass
2
, G. Tröster
2
, M. Guckenberger
1
1
University Hospital Zürich, Department of Radiation-
Oncology, Zurich, Switzerland
2
ETH Zurich, Wearable Computing Laboratory, Zurich,
Switzerland
Purpose or Objective
Purpose:
One of the critical phases in severely-ill
patients’ trajectories is demission from hospital care. Due
to a lack of pro-active and low-threshold interventions in
the home-care setting, a relevant number of avoidable
emergency visits is observed. The idea of this
collaboration project of the Clinic of Radiation-Oncology
(CRO) USZ and ETH Zurich is an early detection of changes
in crucial symptoms by using wireless activity tracking
technology. This allows for non-invasive, objective
measures; additionally, subjective parameters recorded
by questionnaire apps will be captured. Aims of the study
are to evaluate and optimize patients’ acceptance
regarding the supply with a tracking bracelet and a
smartphone in order to monitor objective and subjective
health data and to evaluate correlations between patient-
specific activity patterns and the subjective patients’
ratings of pain, distress and quality of life (QoL).
Material and Methods
Methods
: Explorative, descriptive design. Recruitment of
30 participants on the different wards of the CRO
(radiation-oncology,
palliative).
Application
of
semiquantitative questionnaires and guideline interviews
to evaluate patients’ usage and acceptance of technical
devices. Extraction of sensor data (body motion, social
features, heart rate, speech) using signal processing
methods from smartphone und wristband. Capturing of
subjective health data via electronical version of VAS-pain
(daily), of NCCN Distress Thermometer (daily) and EORTC
– QLQ C30 (paper version, weekly). First pre-studies on (a)
semi-qualitative evaluation of device, app and study
acceptance and (b) optimization of patient inclusion
criteria and estimation of recruitment as well as (c) a pilot
of wireless tracking in three patients have been conducted
at time of abstract submission.
Results
Results
: According to the pre-studies severely-ill and
palliative patients are willing and able to use smartphones
and wristbands and have a positive attitude towards the
proposed monitoring systems. Sixty percent of eligible
patients declared potential interest to participate.
Preliminary data analysis from the pilot support our
hypothesis that it is possible to receive exploitable data
from mobile devices carried by discharged patients. In May
2017, then having started the main study, we will present
more of quantitative evaluation data as well as first data
extracted from the activity trackers (smartphone and
bracelet).
Conclusion
Conclusion:
Our project will deliver relevant data on
patients’ acceptance of wireless tracking, as well as
correlation between subjective symptom assessment and
objective activity data. The study is meant to be
preparatory work for an intervention study to test the
effect of wireless monitoring on early symptom relief,
quality of life and prevention of avoidable hospitalization
in the group of the severely-ill and palliative care
patients.
EP-1387 Time Trends In Opioid Use In Cancer Patients
with Pain: Observations from Administrative Data
L. Barbera
1
, C. DeAngelis
2
, C. Earle
3
, C. Atzema
4
, D.
Dudgeon
5
, D. Howell
6
, A. Husain
7
, M.A. O'Brien
8
, H.
Seow
9
, J. Sussman
10
, R. Sutradhar
11
, A. Chu
11
, Y. Liu
11
1
Odette Cancer Centre - Sunnybrook Health Sciences
Centre, Radiation Oncology, North York- Toronto,
Canada
2
Odette Cancer Centre - Sunnybrook Health Sciences
Centre, Pharmacy, North York- Toronto, Canada
3
Sunnybrook Health Sciences Centre, Medicine, North
York- Toronto, Canada
4
Sunnybrook Health Sciences Centre, Medicine, Toronto,
Canada
5
Queen's University, Medicine and Oncology, Kingston,
Canada
6
University Health Network, Oncology Nursing, Toronto,
Canada
7
Mount Sinai Hospital, Temmy Latner Centre for
Palliative Care, North York- Toronto, Canada
8
University of Toronto, Family and Community Medicine,
Toronto, Canada
9
McMaster University, Oncology, Hamilton, Canada
10
Juravinski Cancer Centre, Radiation Oncology,
Hamilton, Canada
11
Institute of Clinical Evaluative Sciences, Cancer
Research, Toronto, Canada
Purpose or Objective
Objective: Previous work in Ontario demonstrated that
33% of cancer patients with severe pain (7-10/10) did not
receive opioids at the time of their pain assessment. The
objective of this study was to examine temporal trends in
opioid prescribing among cancer patients with different
pain severity.
Material and Methods
Approach: Our study cohort comprised of Ontario residents
≥18 years with a history of cancer who were eligible for
the government’s paid pharmacare program and who had
a pain assessment using the Edmonton Symptom
Assessment Scale (ESAS). Use of ESAS is the result of a
population-based provincial initiative to screen
ambulatory cancer patients for 9 common cancer
symptoms. For each year between 2007 and 2013, we
used the date of an individual’s highest pain score as the
index date to calculate annual opioid prescription rates
for claims within -30 days to +7 days of the index date. We
evaluated prescriptions for drugs for neuropathic pain as
a secondary outcome.
Results
Results: During the study period, individuals meeting the
cohort inclusion criteria increased over 7-fold with 12,066
individuals aged 18-64 years and 43,715 individuals aged
³65 years eligible in 2013. Over time, changes in the
distribution of patients across cancer types and pain
scores were observed. For example, for those aged 18-64,
33% of patients had pain 7-10 in 2007 decreasing to 22%
with pain 7-10 in 2013. Similarly, for those aged ≥65, 21%
had pain 7-10 in 2007 decreasing to 11% in 2013. In both
age groups, opioids were prescribed most frequently for
those with pain 7-10 and least frequently for those with
no pain. Among 18-64 year olds with pain 7-10, opioid
prescription rates decreased from 46% in 2007 to 38% in
2013 (p<0.05). The respective values for those ³65 years
were 61% to 39% (p<0.05). Prescriptions for drugs for
neuropathic pain increased modestly.
Conclusion
Conclusion: Over time, pain assessment among cancer
patients has increased. However, the proportion with pain
who receive an opioid prescription has decreased. This
finding may be due to increased detection of non-cancer
related pain, but may also be the result of increased
scrutiny of opioid prescribing and policy changes intended
to decrease prescribing in non-cancer patients.
EP-1388 Clinical features of bone metastases and
their importance for radiotherapy