The role of patient-reported outcomes in outpatients receiving active anti-cancer treatment: impact on patients' quality of life
The role of patient-reported outcomes in outpatients receiving active anti-cancer treatment: impact on patients' quality of life
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DOI：
10.1007/s00520-019-04777-2
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发表时间：
2019-12-01
影响因子：
3.1
通讯作者：
Di Maio, Massimo
中科院分区：
文献类型：
--
作者：
Baratelli, Chiara;Turco, Carmela Giovanna Cleopatra;Di Maio, Massimo
引言患者报告结局（PRO）是描述主观症状的金标准。护士可以成功地参与收集症状信息，因为他们与病人的直接关系。为了改善接受积极抗癌治疗的门诊患者的临床管理，我们从2018年1月开始在常规临床实践中引入了对患者报告的症状和毒性的评估。我们的假设是，这可能有助于更好地控制症状，改善患者的生活质量（QoL）。方法对符合条件的患者进行积极的抗肿瘤治疗。对照组（2017年接受治疗）的患者接受“常规”访视（A组），而2018年接受治疗的患者在每次访视前接受专门护士的问卷调查，以提供有关症状和毒性的信息（B组）。主要目标是比较通过EORTC QLQ-C30测量的生活质量变化。结果共分析211例患者（A组119例; B组92例）。1个月后，A组总体生活质量较基线的平均变化为-1.68，B组为+2.54（p = 0.004，效应量0.20）。组B显示出显著更好的疲劳、疼痛和食欲不振的平均变化。B组总体QoL评分获得临床显著改善的患者比例（32.6%）高于A组（19.3%，p = 0.04）。患者对问卷的满意度较高。结论在临床实践中引入PRO，由于护士的积极作用，是可行的，产生了较高的患者满意度和显着的生活质量改善，相比传统的访问模式。
Introduction Patient-reported outcomes (PROs) are the gold standard to describe subjective symptoms. Nurses can be successfully involved in collecting symptom information, because of their direct relationship with the patient. In order to improve clinical management of outpatients receiving active anti-cancer treatment, we introduced in routine clinical practice an assessment of patient-reported symptoms and toxicities, starting from January 2018. Our hypothesis was that this could help to better control symptoms, improving patients' quality of life (QoL). Methods Eligible patients were receiving an active anti-cancer treatment, as outpatients. Patients included in the control group (treated in 2017) underwent "usual" visits (group A), while patients treated in 2018, before each visit received a questionnaire by a dedicated nurse, in order to provide information about symptoms and toxicities (group B). Primary objective was the comparison of QoL changes, measured by EORTC QLQ-C30. Results A total of 211 patients have been analyzed (119 group A; 92 group B). After 1 month, mean change from baseline of global QoL was - 1.68 in group A and + 2.54 in group B (p = 0.004, effect size 0.20). Group B showed significantly better mean changes for fatigue, pain, and appetite loss. Proportion of patients obtaining a clinically significant improvement in global QoL score was higher in group B (32.6%) compared to group A (19.3%, p = 0.04). Patients' satisfaction with questionnaire was high. Conclusion Introduction of PROs in clinical practice, thanks to an active role of nurses, was feasible, produced high patients' satisfaction and a significant QoL improvement, compared to the traditional modality of visit.