Patient and physician quality of life assessment in a gynecologic oncology clinic

Abstract

8251 Background: Accurate quality of life (QOL) assessment is an important consideration during and after cancer treatment. Patient and physician assessments are known to differ. We determined effectiveness of the systematic use of questionnaires at patient visits. Methods: A convenience sample of consecutive patients was assessed during (n=58) and after (n=43) chemotherapy. At visit 1 performance status (PS, Karnofsky Scale) and global QOL assessment with a hundred millimeter scale (UNISC) were used. At visit 2 and 3 the PS, UNISC, Functional Assessment of Cancer Therapy-G (FACT) and Center for Epidemiologic Studies-Depression (CES-D) were administered. A questionnaire regarding patient satisfaction was completed each time. The physician assessed patient PS and UNISC after each visit. Spearman correlation coefficients were used for statistical evaluation. Results: At visit 1 assessment of PS by the physician was identical to the patient in 63%, one grade higher in 20% and one grade lower in 17%; QOL assessed by the physician with the UNISC was within 10 points of the patient assessment in 50% and within 20 points in 78%. Results were similar after visits 2 and 3. Patients reported excellent satisfaction with their office visit at each time with an average score of 51 out of 55 points. Answering the questionnaires helped them think about their life (83%); helped them talk to the physician (67%) and gave their physician a better understanding of their situation (88%). More patients reported depressive symptoms (CES-D score > 17), during chemotherapy (50%) than during follow up (35%). The UNISC correlated highly with the physical, functional and overall FACT score. It took an average time of 8 minutes to complete the questionnaires. Conclusion: Systematic QOL assessment and depression screening can be efficiently delivered during a routine clinic visit. This adds and may clarify patient QOL and psychological status beyond the office visit interview alone. Single item measures may be the most useful in this situation and can be followed by more extensive assessment as necessary. No significant financial relationships to disclose.