gms | German Medical Science

Objective: Distress and need of support in glioma patients may remain unrecognized as these patients may not be able (mentally or physically) to complete self-report instruments applied in screening procedures. An alternative approach is to (re-)integrate the assessment in the doctor-patient consultation. The aim of the project is to prepare a list of questions that could be used for such an approach in clinical routine.

Methods: We performed 1) a literature research 2) structured interviews in glioma patients in an outpatient setting and 3) an online expert survey. Patients and experts estimated the most important items and questions of psychosocial topics on a Likert scale (0-6). Patients responded to whether the item afflicted them during the last week or not. Further, sociodemographic and clinical data were obtained. The three most important main topics based on experts' and patients' ratings as well as whether or not the items affected the patients were identified by a weighted scoring procedurein order toconstitute three main questions we recommend to ask.

Results: From July 13th to October 12th 2017, n=93 eligible patients were approached and n= 50 patients were included. Median age was 56 years (range 30-79 y). n=35 were male, n=46 suffered from a high-grade glioma. Reasons for non-inclusion were diagnosis other than glioma (n=15), not being able to understand German (n=7), relative was present instead of the patient (n=2) and for declining were exhaustion (n=9), time constraints (n=4) and not being interested in participating in the study (n=6). Mean time of interviews was 17 min (range 9-35 min). Patients indicated the topics "cognitive", "mental" and "physical problems" as well as "problems concerning job andleasure time" to be nearly equally important with emphasis on the issues "fatigue" and "future uncertainty". N=36 eligible experts (n=20 are neurosurgeons) answered the survey; we observed a tendency towards "physical" and "cognitive problems" with emphasis to "seizure" and "depressive symptoms".

Conclusion: Patient reported outcome measures are indispensable. Yet, further optimization in glioma patients' assessment is required. Our study indicated 3 areas most important for patients with gliomas according to expert analysis and the patients' estimation: cognitive, physical and mental problems. The corresponding questions could be implemented in clinical consultation and help to screen patients beyond questionnaires assessment or screening instruments.