Health-related quality of life and patient reported outcomes among people living with HIV and cancer

艾滋病毒和癌症患者的健康相关生活质量和患者报告的结果

• 批准号: 10758118
• 负责人: Jessica Yasmine Islam
• 金额: $ 16.85万
• 依托单位: H. LEE MOFFITT CANCER CTR & RES INST
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-16 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10758118
• 关键词: Activities of Daily Living; Address; Adult; Affect; Age; Aging; Anus; CD4 Lymphocyte Count; Cancer Patient; Caring; Cessation of life; Client satisfaction; Clinical; Colorectal Cancer; Complement; Data; Data Collection; Data Linkages; Data Reporting; Development; Diagnosis; Discrimination; Elderly; Esophagus; Face; Female Breast Carcinoma; Florida; Future; General Population; Goals; HIV; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; Head and neck structure; Health; Health Surveys; Highly Active Antiretroviral Therapy; Hospitalization; Immunosuppression; Intervention; Larynx; Life Expectancy; Liver; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurement; Measures; Medicare; Medicare claim; Mental Health; Methods; Morbidity - disease rate; NCI-Designated Cancer Center; Older Population; Oral cavity; Outcome; Outcome Assessment; Pain; Pancreas; Patient Monitoring; Patient Outcomes Assessments; Patient Self-Report; Patient-Centered Care; Patients; Persons; Pharyngeal structure; Physical Function; Population; Quality of life; Reporting; Research; Risk; Role; SEER Program; Solid Neoplasm; Stomach; Supportive care; Surveys; Survival Analysis; Symptoms; United States Centers for Medicare and Medicaid Services; Upper digestive tract structure; Veterans; Vulnerable Populations; Work; cancer care; cancer diagnosis; cancer risk; cancer therapy; care delivery; comorbidity; data registry; experience; financial toxicity; hazard; health related quality of life; improved; innovation; lens; marginalization; mortality; neoplasm registry; older patient; outcome disparities; patient population; patient-clinician communication; physical conditioning; social; social factors; social stigma; survival disparity; symptom management; symptomatic improvement; therapy design; treatment response; tumor progression; understudied cancer

PROJECT SUMMARY Advances in HIV treatment have improved life expectancy among people with HIV (PWH). As PWH live longer, they are at increased risk for cancer and cancer-related mortality compared with the general population. However, it remains unclear what factors may contribute to persistent survival disparities and poor cancer outcomes among PWH in the US. Integrating measurement of patient-reported outcomes (PROs) into routine and supportive cancer care is a potential strategy to improve PWH’s quality of life, cancer outcomes, and survival. PROs encompass data reported directly by patients to describe how they feel and function, such as symptoms, physical function, and health-related quality of life. In the general (i.e., HIV-uninfected) cancer patient population, PRO scores are associated with several adverse cancer clinical outcomes including poor response to therapy, cancer progression, and shorter survival. Given that PWH are also more likely to be diagnosed with non-AIDS defining cancers at later stages and experience elevated mortality, it is urgent to investigate opportunities, such as the role of PROs, to improve survival and ultimately reduce preventable cancer deaths among PWH. However, to our knowledge, no research exists in the context PROs and overall health-related quality of life among PWH with cancer. To address this research gap, our objective is to evaluate physical and mental health symptomology (PROs) throughout the cancer diagnosis trajectory and associations with cancer outcomes among HIV-positive cancer patients. We propose a two-pronged approach: we will leverage an existing, NCI-sponsored, data linkage between the Surveillance, Epidemiology, and End Results (SEER) cancer registry data and Centers for Medicare and Medicaid Services (CMS)’ Medicare Health Outcomes Survey (MHOS) (Aims 1 and 2) and conduct primary data collection among HIV positive cancer patients treated at an NCI-designated cancer center (Aim 3). We will carry out the following specific aims: Aim 1: Compare changes in patient reported outcomes (PROs) after a cancer-diagnosis among non-AIDS defining cancer patients living with and without HIV; Aim 2: Estimate associations of PROs (pre-diagnosis, post-diagnosis, and change in PROs) with overall survival among older patients diagnosed with non-AIDS defining cancers with HIV; and Aim 3: Explore the role of HIV-specific clinical and social factors in patient reported outcome assessments among a broad age range of HIV positive cancer patients treated at one NCI-designated cancer center. Findings from this research will provide preliminary data to inform the development of future large-scale R01-level research opportunities focused on improving symptom control among PWH with cancer and evaluating the integration of tailored patient-reported outcome data collection into routine supportive care of this vulnerable population.

项目摘要 艾滋病毒治疗的进步提高了艾滋病毒感染者的预期寿命。随着威尔斯亲王医院的寿命延长， 与一般人口相比，他们患癌症的风险和与癌症有关的死亡率更高。 然而，目前还不清楚是什么因素可能导致持续的生存差异和癌症 在美国PWH中的结果。将患者报告结局（PRO）的测量纳入常规 支持性癌症护理是改善威尔斯亲王医院生活质量、癌症预后和生存率的潜在策略。 PRO包括患者直接报告的数据，以描述他们的感觉和功能，如症状， 身体功能和健康相关的生活质量。在一般情况下（即，未感染HIV的）癌症患者群体， PRO评分与几种不利的癌症临床结果相关，包括对治疗的不良反应， 癌症进展和更短的生存期。鉴于威尔斯亲王医院的病人被诊断为非爱滋病的机会亦较大， 在晚期阶段定义癌症并经历死亡率升高，迫切需要调查机会， 作为PRO的作用，以提高生存率，并最终减少可预防的癌症死亡在威尔斯亲王医院。然而，在这方面， 据我们所知，目前还没有针对PWH中的PRO和整体健康相关生活质量的研究 得了癌症为了弥补这一研究空白，我们的目标是评估身心健康的生物学 （PRO）在整个癌症诊断轨迹和与艾滋病毒阳性患者的癌症结局的关联 癌症患者。我们提出了一个双管齐下的方法：我们将利用现有的，由国家癌症研究所赞助的，数据链接 监测、流行病学和最终结果（SEER）癌症登记数据与医疗保险中心之间 和医疗补助服务（CMS）的医疗保险健康结果调查（MHOS）（目标1和2），并进行主要 在NCI-designated cancer center接受治疗的HIV阳性癌症患者中收集数据（Aim 3）。我们将 目标1：比较治疗后患者报告结局（PRO）的变化， 非艾滋病定义的癌症患者中的癌症诊断;目标2：估计 PRO（诊断前、诊断后和PRO变化）与老年人总生存率的相关性 目的3：探讨HIV特异性临床诊断的作用， 在广泛年龄范围的HIV阳性癌症患者中，患者报告的结局评估中的社会因素 在一个NCI指定的癌症中心接受治疗的患者。这项研究的结果将提供初步数据 告知未来大规模R 01级研究机会的发展，重点是改善症状 在患有癌症的PWH中进行控制，并评估定制的患者报告结局数据的整合 收集到这些弱势群体的日常支持性护理。