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Edmonton Symptom Assessment System (ESAS-r)

What is known

ESAS-r is a validated tool developed in Canada. It is designed to be incorporated into routine documentation about patient care, and uses a set of simple visual analogue scales to track patient symptoms over time. [1] It is validated in a range of clinical settings, and has also been used as a research tool in studies where monitoring of palliative care patients’ symptoms are required.

The information can be completed by the patient, with help from a caregiver, or by a caregiver. 

Implications for practice

  • ESAS charts provide a useful simple representation of symptom control which can be communicated between different teams, disciplines or settings. [1]
  • It does not address aspects of palliative care service delivery beyond symptom control, and does not collect information about families.
  • The validity of the ESAS in patients with cognitive problems, language or literacy difficulties, or neurological problems has not been established. Patients must be shown how to complete the ESAS scores, and their understanding checked and re-checked at intervals. [1]

Finding out more

Related CareSearch pages



  1. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991 Summer;7(2):6-9.

Last updated 26 May 2008