Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: main results of a cluster preference randomised controlled trial.

Head and neck cancer Intervention Patient concerns inventory Patient-reported outcomes Quality of life Randomised trial

Journal

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 06 09 2020
accepted: 27 11 2020
pubmed: 22 12 2020
medline: 5 8 2021
entrez: 21 12 2020
Statut: ppublish

Résumé

The patient concerns inventory (PCI) is a prompt list allowing head and neck cancer (HNC) patients to discuss issues that otherwise might be overlooked. This trial evaluated the effectiveness of using the PCI at routine outpatient clinics for one year after treatment on health-related QOL (HRQOL). A pragmatic cluster preference randomised control trial with 15 consultants, 8 'using' and 7 'not using' the PCI intervention. Patients treated with curative intent (all sites, disease stages, treatments) were eligible. Consultants saw a median (inter-quartile range) 16 (13-26) patients, with 140 PCI and 148 control patients. Of the pre-specified outcomes, the 12-month results for the mean University of Washington Quality of Life (UW-QOLv4) social-emotional subscale score suggested a small clinical effect of intervention of 4.6 units (95% CI 0.2, 9.0), p = 0.04 after full adjustment for pre-stated case-mix. Results for UW-QOLv4 overall quality of life being less than good at 12 months (primary outcome) also favoured the PCI with a risk ratio of 0.83 (95% CI 0.66, 1.06) and absolute risk 4.8% (- 2.9%, 12.9%) but without achieving statistical significance. Other non-a-priori analyses, including all 12 UWQOL domains and at consultant level also suggested better HRQOL with PCI. Consultation times were unaffected and the number of items selected decreased over time. This novel trial supports the integration of the PCI approach into routine consultations as a simple low-cost means of benefiting HNC patients. It adds to a growing body of evidence supporting the use of patient prompt lists more generally.

Identifiants

pubmed: 33346856
doi: 10.1007/s00405-020-06533-3
pii: 10.1007/s00405-020-06533-3
pmc: PMC7751263
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

3435-3449

Subventions

Organisme : Department of Health
ID : PB-PG-0215-36047
Pays : United Kingdom
Organisme : Research for Patient Benefit Programme
ID : PB-PG-0215-36047

Informations de copyright

© 2020. The Author(s).

Références

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Auteurs

Simon N Rogers (SN)

Faculty of Health and Social Care, Edge Hill University, Ormskirk, Liverpool, L39 4QP, UK. simonn.rogers@aintree.nhs.uk.
Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK. simonn.rogers@aintree.nhs.uk.

Christine Allmark (C)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

Fazilet Bekiroglu (F)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Rhiannon Tudor Edwards (RT)

Centre for Health Economics and Medicines Evaluation (CHEME), School of Health Sciences, College of Human Sciences, Ardudwy Hall, Normal Site, Bangor University, Bangor, Wales, UK.

Gillon Fabbroni (G)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

Robert Flavel (R)

, Southway, Guilford, Surrey, UK.

Victoria Highet (V)

Liverpool Head and Neck Clinical Trials, Clinical Sciences Building, University Hospital Aintree, Liverpool, UK.

Michael W S Ho (MWS)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

Gerald M Humphris (GM)

School of Medicine, Medical & Biological Sciences, North Haugh, St Andrews, UK.

Terry M Jones (TM)

Liverpool Head and Neck Centre, University of Liverpool, Cancer Research Centre, University of Liverpool, 200 London Road, Liverpool, L3 9GA, UK.

Owais Khattak (O)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Jeffrey Lancaster (J)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Christopher Loh (C)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Derek Lowe (D)

Astraglobe Ltd, Congleton, Cheshire, UK.

Cher Lowies (C)

Liverpool Head and Neck Clinical Trials, Clinical Sciences Building, University Hospital Aintree, Liverpool, UK.

Dominic Macareavy (D)

Chair of the Head and Neck Patient and Carer Research Forum, Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

James Moor (J)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

T K Ong (TK)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

A Prasai (A)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

Nicholas Roland (N)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Cherith Semple (C)

Institute of Nursing and Health Research, Ulster University, Shore Road, Belfast, Newtownabbey, Co, BT37 0QB, Antrim, Belfast, UK.
South Eastern Health and Social Care Upper Newtownards Road, Belfast, BT16 1RH, UK.

Llinos Haf Spencer (LH)

Centre for Health Economics and Medicines Evaluation (CHEME), School of Health Sciences, College of Human Sciences, Ardudwy Hall, Normal Site, Bangor University, Bangor, Wales, UK.

Sank Tandon (S)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Steven J Thomas (SJ)

Oral and Maxillofacial Surgery Department, Bristol University, Lower Maudlin Street, Bristol, UK.

Andrew Schache (A)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Richard J Shaw (RJ)

Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.

Anastasios Kanatas (A)

Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, UK.

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