Abstract
BackgroundOutpatient cancer chemotherapy may lead to improved quality of life (QOL) by allowing treatment to continue without impairing the social lives of patients compared with hospitalization. However, the occurrence of serious adverse events may cause a decline in QOL. We investigated the relationship between outpatient chemotherapy–induced adverse events and QOL.MethodsA single-center retrospective descriptive study was conducted in patients who received outpatient chemotherapy at Gifu University Hospital (Gifu, Japan) between September 2017 and December 2018. The utility values of QOL, type and severity of adverse events, type of cancer, chemotherapy regimen, and other patient demographics were analyzed. Adverse events were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L). Associations between the EQ-5D-5L utility value and serious adverse events were assessed using adjusted (age and sex) odds ratios obtained with a proportional odds logistic regression model.ResultsData from 1008 patients who received 4695 chemotherapy cycles were analyzed. According to proportional odds logistic regression, the adverse events that significantly correlated with a decreased EQ-5D-5L utility value were malaise, edema of the limbs, peripheral neuropathy, pruritus, and dry skin. Based on the proportional odds logistic analysis, neither cancer type nor anticancer drugs were significantly correlated with the EQ-5D-5L utility value in patients who received chemotherapy. Pharmaceutical care for peripheral neuropathy significantly improved patients’ EQ-5D-5L utility value from 0.747 to 0.776 (P < 0.01).ConclusionsAdverse events (i.e., peripheral neuropathy, malaise, and edema of the limbs) are significantly correlated with a decrease in QOL, regardless of the type of cancer or anticancer drugs used. Pharmaceutical care provided by pharmacists in collaboration with physicians may improve QOL.
Highlights
The number of patients who undergo cancer chemotherapy is increasing in parallel with the morbidity and mortality associated with cancer worldwide
Hagiwara et al [10] showed that grade 1 oral mucositis, grade 1 and 2 fatigue, and grade 2 sensory neuropathy were significantly associated with impaired global health status in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 in patients receiving firstline chemotherapy for metastatic breast cancer
The mean EQ-5D-5L utility value for each patient visit is shown in Supplemental Table 1 by cancer type, regimen, and adverse events
Summary
The number of patients who undergo cancer chemotherapy is increasing in parallel with the morbidity and mortality associated with cancer worldwide. Outpatient cancer chemotherapy is characterized by a high incidence of adverse events [6,7,8], and severe adverse events may directly influence the personal life and work of patients. According to proportional odds logistic regression, the adverse events that significantly correlated with a decreased EQ-5D-5L utility value were malaise, edema of the limbs, peripheral neuropathy, pruritus, and dry skin. Based on the proportional odds logistic analysis, neither cancer type nor anticancer drugs were significantly correlated with the EQ-5D-5L utility value in patients who received chemotherapy. Pharmaceutical care provided by pharmacists in collaboration with physicians may improve QOL
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