Gilbert Scott M, Dunn Rodney L, Wittmann Daniela, Montgomery Jeffrey S, Hollingsworth John M, Miller David C, Hollenbeck Brent K, Wei John T, Montie James E
Genitourinary Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida; Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
Cancer. 2015 May 1;121(9):1484-91. doi: 10.1002/cncr.29215. Epub 2014 Dec 23.
Integrating quality-of-life (QOL) outcomes into clinics may assist providers in identifying and responding to problems experienced by cancer survivors. To date, however, patient-reported outcomes (PROs) such as QOL are used infrequently to guide care. We integrated QOL assessments into a prostate cancer survivorship clinic and compared recovery and satisfaction among men managed in the survivorship clinic with those followed with more routine care.
We conducted a before-after study comparing 235 men treated surgically for prostate cancer who received routine follow-up care with 102 men managed in a survivorship clinic characterized by point-of-care QOL reporting and integration of QOL scores (EPIC) following radical prostatectomy. We then assessed baseline and postprostatectomy QOL at 6 and 12 months, as well as patient satisfaction, and compared outcomes between groups.
Although baseline QOL was comparable, scores were generally higher among the survivorship group at 6 months and 1 year compared with those followed with routine care. In particular, sexual function scores were significantly higher among patients managed in the survivorship clinic (52.2 vs 33.6 at 1 year, P < .01). Satisfaction scores were consistently higher in the survivorship clinic group compared with the routine-care group (all P < .05).
Patient QOL and satisfaction were higher among men managed in a survivorship program, suggesting that disease-specific survivorship clinics that integrate QOL reporting into care pathways may yield better outcomes compared with less tailored approaches to patient care following cancer therapy.
将生活质量(QOL)结果纳入临床诊疗可能有助于医疗服务提供者识别并应对癌症幸存者所经历的问题。然而,迄今为止,诸如生活质量等患者报告结局(PROs)很少被用于指导治疗。我们将生活质量评估纳入前列腺癌幸存者诊所,并比较了在该幸存者诊所接受管理的男性与接受更常规治疗的男性之间的恢复情况和满意度。
我们进行了一项前后对照研究,比较了235名接受前列腺癌手术治疗并接受常规随访的男性与102名在以即时生活质量报告和前列腺癌根治术后生活质量评分(EPIC)整合为特征的幸存者诊所接受管理的男性。然后,我们在6个月和12个月时评估了基线和前列腺切除术后的生活质量,以及患者满意度,并比较了两组之间的结果。
尽管基线生活质量相当,但与接受常规治疗的男性相比,幸存者组在6个月和1年时的评分总体上更高。特别是,在幸存者诊所接受管理的患者性功能评分显著更高(1年时为52.2对33.6,P < .01)。与常规治疗组相比,幸存者诊所组的满意度评分一直更高(所有P < .05)。
在幸存者项目中接受管理的男性患者的生活质量和满意度更高,这表明将生活质量报告纳入护理路径的特定疾病幸存者诊所与癌症治疗后对患者护理的定制性较差的方法相比,可能会产生更好的结果。