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通过常规使用头颈部癌症患者关注事项清单提高生活质量:一项聚类偏好随机对照试验。

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

机构信息

Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK.

Edge Hill University, Liverpool and Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Road, L39 4QP, Ormskirk, St Helens, UK.

出版信息

BMC Cancer. 2018 Apr 18;18(1):444. doi: 10.1186/s12885-018-4355-0.

Abstract

BACKGROUND

The consequences of treatment for Head and Neck cancer (HNC) patients has profound detrimental impacts such as impaired QOL, emotional distress, delayed recovery and frequent use of healthcare. The aim of this trial is to determine if the routine use of the Patients Concerns Inventory (PCI) package in review clinics during the first year following treatment can improve overall quality of life, reduce the social-emotional impact of cancer and reduce levels of distress. Furthermore, we aim to describe the economic costs and benefits of using the PCI.

METHODS

This will be a cluster preference randomised control trial with consultants either 'using' or 'not using' the PCI package at clinic. It will involve two centres Leeds and Liverpool. 416 eligible patients from at least 10 consultant clusters are required to show a clinically meaningful difference in the primary outcome. The primary outcome is the percentage of participants with less than good overall quality of life at the final one-year clinic as measured by the University of Washington QOL questionnaire version 4 (UWQOLv4). Secondary outcomes at one-year are the mean social-emotional subscale (UWQOLv4) score, Distress Thermometer (DT) score ≥ 4, and key health economic measures (QALY-EQ-5D-5 L; CSRI).

DISCUSSION

This trial will provide knowledge on the effectiveness of a consultation intervention package based around the PCI used at routine follow-up clinics following treatment of head and neck cancer with curative intent. If this intervention is (cost) effective for patients, the next step will be to promote wider use of this approach as standard care in clinical practice.

TRIAL REGISTRATION

32,382. Clinical Trials Identifier, NCT03086629 .

PROTOCOL

Version 3.0, 1st July 2017.

摘要

背景

头颈部癌症(HNC)患者治疗的后果会产生深远的负面影响,如生活质量受损、情绪困扰、恢复延迟和频繁使用医疗保健。本试验的目的是确定在治疗后第一年的复查门诊中常规使用患者关注量表(PCI)包是否可以提高总体生活质量、减轻癌症的社会情绪影响并降低困扰程度。此外,我们旨在描述使用 PCI 的经济成本和收益。

方法

这将是一项集群偏好随机对照试验,顾问在诊所中“使用”或“不使用” PCI 包。它将涉及两个中心:利兹和利物浦。需要从至少 10 个顾问群组中招募 416 名符合条件的患者,以显示主要结局的临床有意义差异。主要结局是使用华盛顿大学生活质量问卷第四版(UWQOLv4)测量的最后一年门诊中,生活质量低于良好的参与者比例。一年时的次要结局是社会情绪子量表(UWQOLv4)的平均评分、痛苦温度计(DT)评分≥4 以及关键健康经济措施(QALY-EQ-5D-5 L;CSRI)。

讨论

本试验将提供有关在有治愈意图的头颈部癌症治疗后常规随访门诊中使用 PCI 为基础的咨询干预包有效性的知识。如果这种干预措施对患者有效(成本),下一步将是促进更广泛地将这种方法作为临床实践中的标准护理进行推广。

试验注册

32,382. 临床试验标识符,NCT03086629。

方案

第 3.0 版,2017 年 7 月 1 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c66a/5907378/34bc83b8a33d/12885_2018_4355_Fig1_HTML.jpg

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