Johnston Donna, Gerbing Robert, Alonzo Todd, Aplenc Richard, Nagarajan Rajaram, Schulte Fiona, Cullen Patricia, Sung Lillian
Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Children's Oncology Group, Monrovia, California, United States of America.
PLoS One. 2015 Apr 27;10(4):e0125290. doi: 10.1371/journal.pone.0125290. eCollection 2015.
Health related quality of life (HRQL) assessments during therapy for pediatric cancer provide valuable information to better understand the patient experience. Our objective was to determine the impact of a patient-reported outcome (PRO) coordinator on HRQL questionnaire completion rates during a pediatric acute myeloid leukemia (AML) trial.
AAML1031 is a multicenter Children's Oncology Group therapeutic trial for de novo AML with a secondary aim to assess HRQL of children and adolescents treated with chemotherapy and hematopoietic stem cell transplantation (HSCT). Parents/guardians are the primary respondents and four questionnaires are administered at eight time points. The questionnaires are the PedsQL 4.0 Generic Core Scales, PedsQL 3.0 Acute Cancer Module, PedsQL Multidimensional Fatigue Scale, and the Pediatric Inventory for Parents. To improve response rates, a central PRO coordinator was instituted and reminded sites about upcoming and delinquent questionnaires. The proportion of HRQL questionnaires completed were compared prior to, and following institution of the PRO coordinator. This analysis evaluated the first five assessment time points.
There were231 families who consented to participate in the HRQL aim. Overall response rates for all questionnaires were 73-83%. At time point 1, within 14 days of chemotherapy initiation, post-PRO coordinator completion rates were significantly higher for three of four questionnaires. However, the effect was not sustained and at time point 4, one month following last chemotherapy or HSCT, completion rates were significantly lower post-PRO coordinator for all four questionnaires.
Addition of a central PRO coordinator did not result in sustained improvement in HRQL questionnaire completion rates. Efforts to improve response rates must consider other strategies.
儿童癌症治疗期间的健康相关生活质量(HRQL)评估可为更好地了解患者体验提供有价值的信息。我们的目标是确定患者报告结局(PRO)协调员对儿童急性髓系白血病(AML)试验期间HRQL问卷完成率的影响。
AAML1031是一项多中心儿童肿瘤学组针对初治AML的治疗试验,其次要目的是评估接受化疗和造血干细胞移植(HSCT)的儿童和青少年的HRQL。父母/监护人是主要应答者,在八个时间点发放四份问卷。这些问卷分别是儿童生活质量量表4.0通用核心量表、儿童生活质量量表3.0急性癌症模块、儿童生活质量多维疲劳量表和父母儿童问卷。为提高应答率,设立了一名中央PRO协调员,并提醒各研究点注意即将到来和逾期未交的问卷。比较了设立PRO协调员之前和之后HRQL问卷的完成比例。该分析评估了前五个评估时间点。
有231个家庭同意参与HRQL相关研究。所有问卷的总体应答率为73%-83%。在时间点1,即化疗开始后14天内,PRO协调员介入后,四份问卷中的三份完成率显著更高。然而,这种效果并未持续,在时间点4,即最后一次化疗或HSCT后一个月,PRO协调员介入后所有四份问卷的完成率均显著降低。
增加一名中央PRO协调员并未使HRQL问卷完成率得到持续改善。提高应答率的努力必须考虑其他策略。