ESTRO 36 Abstract Book

S734 ESTRO 36 2017 _______________________________________________________________________________________________

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

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