Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden.
Eur J Haematol. 2020 Jun;104(6):571-580. doi: 10.1111/ejh.13399. Epub 2020 Mar 5.
The use of patient-reported outcome (PRO) measured outside clinical trials is not well defined. We report the first analysis of the prospective PRO study within the Swedish acute myeloid leukemia (AML) and the acute lymphoblastic leukemia (ALL) registries.
PRO was requested 6 months after diagnosis. The EORTC Quality of life Questionnaire Core 30-item, the Patient Health Questionnaire-8 (PHQ-8), and questions from a Swedish National Cancer Questionnaire were used.
An invitation letter was sent to 398 patients; 255 (64%) responded, 60% web-based, and 40% on paper. The ALL cohort had lower physical, role and social functioning, higher symptom burden, and more financial difficulties compared to the AML cohort. A PHQ-8 score ≥ 10p, which indicates depression, was reported in 18% of the patients; 33% of these patients reported being prescribed antidepressants. The patients' overall experience of care was satisfying, but more psychological and practical support was desired. There was no difference in survival between patients who reported their PRO and those who did not. Follow-up at 2 and 4 years is ongoing.
PRO collected in a registry-based setting is feasible, but the selection of time points and questionnaires are delicate in a diverse patient population.
在临床试验之外使用患者报告的结局(PRO)的方法尚未明确。我们报告了在瑞典急性髓细胞白血病(AML)和急性淋巴细胞白血病(ALL)登记处进行的前瞻性 PRO 研究的首次分析。
在诊断后 6 个月请求 PRO。使用 EORTC 生活质量问卷核心 30 项、患者健康问卷-8(PHQ-8)和瑞典国家癌症问卷的问题。
向 398 名患者发送了邀请信;255 名(64%)做出回应,60%通过网络,40%通过纸质。与 AML 队列相比,ALL 队列的身体、角色和社会功能较低,症状负担较高,经济困难较多。18%的患者报告 PHQ-8 评分≥10p,表明患有抑郁症;其中 33%的患者报告服用了抗抑郁药。患者对护理的总体体验是满意的,但希望获得更多的心理和实际支持。报告 PRO 的患者与未报告 PRO 的患者之间的生存率没有差异。正在进行 2 年和 4 年的随访。
在登记处进行的 PRO 收集是可行的,但在多样化的患者群体中,时间点和问卷的选择是微妙的。