Patient-Reported Health-Related Quality-of-Life Assessment at the Point-of-Care with Adolescents and Young Adults with Cancer.

Abstract

Advances in health-related quality-of-life (HRQL) measurement enable point-of-care assessments. We incorporated the Patient-Reported Outcomes Measurement Information System (PROMIS®) Global Health Scale in routine outpatient evaluations of adolescent and young adult (AYA) oncology patients and survivors at two geographically distinct U.S. institutions. AYAs (18-39 years old) completed the 10-question PROMIS Global. Summary subscale scores for Global Physical Health (GPH) and Global Mental Health (GMH) were produced using established scoring algorithms (standardized mean = 50, standard deviation = 10). In addition to comparisons by treatment status, associations between lower subscale scores (<45, previously defined as clinically meaningful) and patient characteristics were assessed using two-sample t-tests among those off treatment. Of 147 patients approached, 142 consented. Mean age was 24.6 ± 5.3 years; 53.5% were male; and 61.3% had hematologic malignancies. Most (76%) were off treatment; 43.0% had treatment complications. While mean GPH and GMH scores did not differ from the standardized population mean (GPH, 49.7 ± 8.8, p = 0.73; GMH, 50.5 ± 9.3, p = 0.55), mean GPH scores were lower among those on treatment (44.3 ± 9.0) than off treatment (51.5 ± 8.1, p < 0.0001). There was no difference in GMH scores by treatment status. Among those off treatment, 26.9% of GPH and 22.2% of GMH scores were <45. The only factor associated with lower GPH scores was treatment complications; no factors were associated with lower GMH scores. Point-of-care HRQL assessment with AYAs is feasible. Among patients off treatment, GPH scores were lower for patients with treatment complications. Further research is needed to understand factors associated with lower GMH scores in this AYA oncology population.