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. Author manuscript; available in PMC: 2016 Jan 1.
Published in final edited form as: J Pain Symptom Manage. 2014 May 29;49(1):13–26. doi: 10.1016/j.jpainsymman.2014.05.003

Table 1.

Patient-Reported and Clinical Data Collected at Each Visit

Patient-Reported Data Clinical Data from Medical
Record
Symptoms Pain intensity (Pain Numeric Rating Scale26), quality, and pattern (investigator developed items)
Dyspnea, fatigue, insomnia, anorexia, and overall symptom distress (Symptom Distress Scale44)
Depression (Personal Health Questionnaire-945)
Anxiety (Hospital Anxiety and Depression Scale46)
Opioid-induced constipation (Constipation severity measure47 and Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events – PRO-CTCAE v373, 74)
Alcohol risk and drug allergiesa Risk for hazardous alcohol use (Alcohol Use Disorders Identification Test48)
Drug allergies
Comorbidities a History of peptic ulcer disease
Cancer therapy Start and end dates of all regimens of chemotherapy, radiation, or targeted therapy
Lab values for visit date Platelet count, serum creatinine, hemoglobin
Patient characteristics Age, weight on visit date
Supportive care medications Prescribed medications with dose and frequency (opioid and non-opioid pain medications, antidepressants, anxiolytics, hypnotics, psychostimulants, laxatives)
Actual use of prescribed and over-the-counter supportive care medications
a

Data collected once at the beginning of the study and used at each visit.