O2-16-4 - “Treatment Goal” and “Wishes Upon Diagnosis”: Comparative Study of Advanced Lung Cancer Patients and Pulmonologists

Abstract

Background: Though it is important to take into account evidence, clinical expertise, and patient values in order to practice EBM, in Japan, not many studies focus on patient values. This study explores the value of both patients and Health Care Professionals (HCP) to find gaps and similarities between them.Study population: The study was conducted in December 2012 via internet using market research firm panels. 1477 completed the self-administered questionnaire, but data derived from 43 advanced lung cancer (LC) patients and 100 physicians treating LC is included in this study.Methods: The same questionnaire was used by both groups, with patients answering about their own experience and physicians answering hypothetically “what if you are diagnosed with advanced cancer”. To investigate the most important treatment goal, respondents rated the top 5 they most prefer out of 12 criteria related to efficacy and QOL. To explore preferred lifestyle and wishes upon diagnosis, 34 criteria were created referring to FACT-G and expert opinions from survey supervisors. Respondents chose all criteria they would wish for.Results: There were significant differences in 4 out of 12 treatment goal criteria (p < 0.005). Patients most preferred cure (3.4 pts weighted average vs. 1.6 pts by physicians), prolonged survival (2.7/3.4), and side effects alleviation (1.9/1.6). Out of 34 criteria related to lifestyle, significant difference was observed in only 2: spend long time with family (44% by patients/62% by physicians) and feel satisfied with your lifework (23%/48%) (p < 0.05).Conclusions: Though cure is difficult in advanced lung cancer in reality, from patients' points of view, it is natural for them to continue to wish so. For physicians, it is important to acknowledge such gaps and pay attention to realistic wishes (e.g. do what the patient wants to do/ maintain everyday life), and support patients by providing appropriate and close communication.