Using individual quality-of-life information as a clinical tool in patients with advanced cancer.

Abstract

91 Background: Use of quality of life information as a tool to aide decision making in routine clinical practice is uncommon. The Schedule of Evaluation for Individual Quality of Life Direct Weighting (SEIQoL DW) is a measurement tool that captures the multidimensionality and uniqueness of the individual allowing him/her to define areas of importance to their quality of life and to demonstrate its measure of importance. It was hypothesised that routine quality of life measurement of patients followed by graphical presentation of this information to the clinician, may bridge views of clinicians and patients to improve quality of life outcome. Methods: A randomised controlled trial of 65 patients receiving chemotherapy for advanced cancer was conducted to measure differences in perception of quality of life over 4 time-points of patients in the intervention group whose quality of life was reported to the clinical team compared to patients in the control group whose quality of life information was not reported to the clinical team .The primary objective was to compare quality of life outcome and examine differences between groups. Results: Findings demonstrated improvement in quality of life of all patients from baseline to time point 4. (P = > 0.05). The top four cues nominated by patients as important to their quality of life were health (92%), social activity (64%), keeping active (58%) and family support (43%).Closer analysis of these individual cues showed interesting differences between the intervention and control group. Participants in the intervention group demonstrated a 51% improvement in perception of health functioning compared to 19% improvement in perception of health functioning in the control group (p = 0.014).Paradoxically there was a decline in patient perception of functioning in other cues (social activity, keeping active and family support) with no significant difference between groups. Conclusions: Review of Individual QoL assessments by the clinican had a clinically significant impact on the patients reported measurement of ‘health’ thus suggesting that utilisation of QoL measurements by the clinician positively impacts the patient.