Perceptions of medical status and treatment goal among older adults with advanced cancer
| Autor: | Areej El-Jawahri, Christine Server, Charn-Xin Fuh, Daniel E. Lage, Vicki A. Jackson, Ryan D. Nipp, Erin Scott, Joseph A. Greer, Sophia Landay, Brandon Temel, Paul Kay, Jennifer S. Temel, Lara Traeger, Leah L. Thompson |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Activities of daily living media_common.quotation_subject Population Treatment goals 03 medical and health sciences 0302 clinical medicine Cost of Illness Quality of life Neoplasms Internal medicine Perception Activities of Daily Living medicine Humans 030212 general & internal medicine education Aged media_common education.field_of_study business.industry Cancer medicine.disease Advanced cancer Oncology 030220 oncology & carcinogenesis Quality of Life Geriatrics and Gerontology Outcomes research business Goals |
| Zdroj: | Journal of Geriatric Oncology. 11:937-943 |
| ISSN: | 1879-4068 |
| Popis: | Background Patient-reported medical status and treatment goal are measures of prognostic understanding with demonstrated relationships to important clinical and patient-reported outcomes in the general cancer population. Among older adults, relationships between these measures and other patient-reported (quality of life [QOL], symptoms, functional impairment) and clinical (hospitalization risk, survival) outcomes remains unclear. Methods We enrolled patients ≥70 with advanced gastrointestinal cancers, collecting patient-reported medical status (terminally ill vs not), treatment goal (curative vs non-curative), QOL (EORTC-Elderly Cancer Patients), symptoms (Edmonton Symptom Assessment System [ESAS]), and functional impairment (activities of daily living [ADLs]). We also obtained information about hospitalizations and survival. To explore relationships between patient-reported medical status, treatment goal, QOL, symptoms, functional impairment, hospitalizations, and survival, we used regression models adjusted for age, sex, and education. Results Of 103 patients, 49.5% reported terminally ill status and 64.0% a non-curative treatment goal. Terminally ill status was associated with worse QOL (EORTC illness burden: 53.59 vs 35.26, p = 0.001), higher symptom burden (ESAS: 28.15 vs 16.79, p = 0.002), more functional impairment (ADLs: 3.63 vs 5.24, p = 0.006), greater hospitalization risk (HR = 2.41, p = 0.020), and worse survival (HR = 1.93, p = 0.010). We did not find associations between patient-reported treatment goal and these outcomes. Conclusions In older adults with advanced cancer, report of terminally ill status was associated with other important patient-reported and clinical outcomes, suggesting disease severity may inform illness perceptions. We did not find similar associations for patient-reported treatment goal, indicating that questions related to medical status and treatment goal measure different constructs and more nuanced measures are needed. |
| Databáze: | OpenAIRE |
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