Preferences for Quality or Length of Life: An Analysis of Patients with Advanced Cancer and Their Family Caregivers Prior to Death (S715)

Abstract

•Describe the demographics of patients with advanced cancer and their family caregivers.•Distinguish the differences in preferences for quality versus length of life between patients with advanced cancer and their family caregivers. Patients with advanced cancer are often faced with difficult decisions throughout their course of treatment and at end of life. These decisions can be influenced by their family caregiver’s preferences for the patient’s cancer treatment. The purpose of this study is to examine the concordance between patients and family caregivers’ preferences for quality or length of life over time. Methods: Using a longitudinal, descriptive study design in this on-going study, we are collecting data on an adult sample of patients with advanced stage GI or lung cancers and their family caregivers (n=41). Using a one item visual analog scale (0-100 with higher number indicating a preference for length of life over quality of life), patients and family caregivers are being asked “regarding your/your loved one’s care, what is most important to you right now?” Data are collected every 3 months until 15 months or patient’s death. 41 patient-family caregiver dyads are included in these analyses. On average, patients died 5.2 months after enrollment into the study. At baseline, patients’ average preference scores were 55.5 (SD=32.8) and family caregivers’ average preference scores were 40.1 (SD=27.1)—this difference was statistically significant (p=.04). At the last assessment prior to death, patient preference scores were 58.3 (33.2) and family caregivers were 34.4 (22.9)—the difference was statistically significant (p=.003). However, when examining differences over time, we found that neither patient (p=.80), family caregiver (p=.26) or differences between patient and family caregiver preferences changed over time (p=.44). Conclusion/Implications: Patients and family caregivers have differing preferences regarding quality versus length of Life and their preferences diverge over time and at end of life. While not statistically significant, attention to these differences could be used to guide conversations between patients and family caregivers regarding preferences at the end of life.