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Understanding Barriers and Distress Experienced Among Cancer Patients: Analysis from an Urban Academic Emergency Department

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Abstract

The purpose of this study was to examine barriers and facilitators to compliance for cancer care in patients utilizing an emergency department (ED)–based assessment. Adult ED patients who either had active cancer or a history of cancer were enrolled between August 2020 and Jan 2022 for this prospective cohort study. We piloted the National Comprehensive Cancer Network (NCCN) Distress Thermometer. Multivariable regression analyses were used to assess the predictors of high distress. Of the 152 patients enrolled, 73% were Black patients, 11% were non-Hispanic White, and 16% included patients from other racial and ethnic groups (including 10.5% Hispanic patients); 73% of the sample had active cancer. The current ED visit was cancer related for 44%. The mean score on the Distress Thermometer was 4 (SD = 2; range 0–8) with 30% having a high distress level of ≥ 6. Having an active cancer and race/ethnicity were significant predictors of high distress. Patients who had active cancer had three times (aOR = 3.01; 95% CI 1.12–8.10) higher odds of experiencing high distress in the past week compared to those who did not have active cancer, after adjusting for race/ethnicity and reason for visit. Practical problems and physical problems were the most common, with 43% (n = 66) and 40% (n = 61) of the patients reporting these problems, respectively. Despite significant progress in cancer care, cancer patients/survivors face difficulty in transitioning between care environments and end up seeking episodic care in the ED and experience a high level of distress.

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Funding

Improving Cancer Survival and Reducing Treatment Variations with Protocols for Emergency Care (ICARE) was funded by the Centers for Disease Control and Prevention (CDC) through the Centers for Research and Demonstration for Health Promotion and Disease Prevention UNIVERSITY OF ILLINOIS 6 U48DP006392-01–01 ILLINOIS PRC CORE + SIP19-007.

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Illinois Chicago, 808 S. Wood St., Chicago, IL, 60612, USA

    Heather Prendergast, Ryan Stratton, Nia Butler & Shaveta Khosla

  2. University of Illinois Cancer Center, Chicago, IL, USA

    Nasima Mannan

Authors
  1. Heather Prendergast
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  2. Ryan Stratton
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  3. Nia Butler
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  4. Nasima Mannan
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  5. Shaveta Khosla
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Correspondence to Shaveta Khosla.

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The study was approved by the Institutional Review Board at University of Illinois Chicago. Participants consented to be a part of the study.

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The authors declare no competing interests.

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Prendergast, H., Stratton, R., Butler, N. et al. Understanding Barriers and Distress Experienced Among Cancer Patients: Analysis from an Urban Academic Emergency Department. J Canc Educ (2024). https://doi.org/10.1007/s13187-024-02435-8

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