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DCTAQ: Daily Chemotherapy Toxicity self-Assessment Questionnaire

In the last 24 hours have you experienced:

1. Nausea (feeling sick)?


Severity:







Level of distress from this symptom:








2. Being sick (vomiting)?


Severity:







Level of distress from this symptom:









3. Diarrhoea?


Severity:







Level of distress from this symptom:









4. Constipation?


Severity:







Level of distress from this symptom:









5.Sore throat?


Severity:







Level of distress from this symptom:









6.Changes in sensation in your hands and/or feet?


Severity:







Level of distress from this symptom:









7. Sore hands and/or feet?


Severity:







Level of distress from this symptom:









8. Flu-like symptoms?


Severity:







Level of distress from this symptom:









9. Tiredness?


Severity:







Level of distress from this symptom:









10. Pain?


Severity:







Level of distress from this symptom:









Location of pain:
11. Any other symptoms you would like to report?


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Daily Chemotherapy Toxicity self Assessment Questionnaire (DCTAQ), Patient Reported Outcome (PRO) tool


Early recognition and management of chemotherapy toxicity is important in reducing complications and contributes to improved quality of life and treatment compliance.

Typically, patients report treatment toxicity during pre-treatment visits but they may also present as an emergency or unscheduled visit with acute symptoms.

Patient Reported Outcomes (PROs) have been proposed as a more efficient method of collecting data on treatment toxicity (1-2), allowing more frequent and systematic monitoring of symptoms.

Maguire et al developed the Daily Chemotherapy Toxicity self-Assessment Questionnaire (DCTAQ) as a novel PRO to enable close monitoring of chemotherapy toxicity in clinical practice (3).

DCTAQ is an 11-item self-reported tool that assesses 10 core chemotherapy related symptoms and item 11 invites patients to report any other symptoms as free text .

Patients are asked to answer all questions based on symptoms experienced in the past 24 hours.

The DCTAQ tool was developed based on an iterative process. Initially an expert and patient panel reviewed a question pool to establish content validity. The tool was field-tested in 82 patients with breast and colorectal cancer receiving adjuvant chemotherapy across 8 hospital sites.

The tool was found to have modest internal consistency and good test-retest reliability with Cohen’s Kappa coefficient >0.8 across most items.

The DCTAQ tool was also used in a multi-centre randomised control trial (eSMART) which investigated real-time monitoring of patient symptoms (4). Patients with non-metastatic breast, colorectal cancer or lymphoma receiving curative intent chemotherapy were randomised to an advanced symptom management system (intervention group) or standard care. Patients in the intervention group reported toxicity by completing the DCTAQ tool and also submitted their body temperature. Symptoms reported using the DCTAQ tool were automatically evaluated and used to generate a colour coded alert to clinicians based on symptom urgency. The trial found that symptom burden, measured using the Memorial Symptom Assessment Scale was significantly lower in the intervention group compared to the standard care group.

Limitations of the DCTAQ tool are that it has only been tested in limited tumour types, settings and a relatively small sample of patients.

References:
  1. Howell D, Molloy S, Wilkinson K, et al. Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol Off J Eur Soc Med Oncol. 2015;26(9):1846-1858. doi:10.1093/annonc/mdv181
  2. Absolom K, Warrington L, Hudson E, et al. Phase III Randomized Controlled Trial of eRAPID: eHealth Intervention During Chemotherapy. J Clin Oncol Off J Am Soc Clin Oncol. 2021;39(7):734-747. doi:10.1200/JCO.20.02015
  3. Maguire R, Kotronoulas G, Donnan PT, et al. Development and preliminary testing of a brief clinical tool to enable daily monitoring of chemotherapy toxicity: The Daily Chemotherapy Toxicity self-Assessment Questionnaire. Eur J Cancer Care (Engl). 2018;27(6):e12890. doi:10.1111/ecc.12890
  4. Maguire R, McCann L, Kotronoulas G, et al. Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART). BMJ. 2021;374:n1647. doi:10.1136/bmj.n1647