title: Symptom burden in chronically ill homebound individuals.
abstract: OBJECTIVE
  To document the degree of symptom burden in an urban homebound population.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  The Mount Sinai Visiting Doctors (MSVD) program.
  
  
  METHODS
  All individuals newly enrolled in the MSVD.
  
  
  METHODS
  Edmonton Symptom Assessment Scale (ESAS), which consists of 10 visual analogue scales scored from 0 to 10; symptoms include pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, shortness of breath, and other.
  
  
  RESULTS
  ESAS scores were completed for 318 participants. Most participants were aged 80 and older (68%) and female (75%); 36% were white, 22% black, and 32% Hispanic. Forty-three percent had Medicaid, and 32% lived alone. Ninety-one percent required assistance with one or more activities of daily living, 45% had a Karnofsky Performance Scale score between 0 and 40 (unable to care for self), and 43% reported severe burden on one or more symptoms. The most commonly reported symptoms were loss of appetite, lack of well-being, tiredness, and pain; the symptoms with the highest scores were depression, pain, appetite, and shortness of breath. Participants were more likely to have severe symptom burden if they self-reported their ESAS, had chronic obstructive pulmonary disease or diabetes mellitus with end organ damage, or had a Charlson Comorbidity Index greater than 3 and less likely to have severe burden if they had dementia.
  
  
  CONCLUSIONS
  In chronically ill homebound adults, symptom burden is a serious problem that needs to be addressed alongside primary and specialty care needs.
authors.affiliation: Mount Sinai Visiting Doctors Program, Division of General Internal Medicine, Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA. ania.wajnberg@mountsinai.org
authors.forename: Ania
authors.initials: A
authors.lastname: Wajnberg
authors.forename: Katherine
authors.initials: K
authors.lastname: Ornstein
authors.forename: Meng
authors.initials: M
authors.lastname: Zhang
authors.forename: Kristofer L
authors.initials: KL
authors.lastname: Smith
authors.forename: Theresa
authors.initials: T
authors.lastname: Soriano
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D018577:Homebound Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D063189:Symptom Assessment / Q000379:methods*; D014481:United States