Epstein Robert S, Basu Roy Upal K, Aapro Matti, Salimi Tehseen, Moran Donald, Krenitsky JoAnn, Leone-Perkins Megan L, Girman Cynthia, Schlusser Courtney, Crawford Jeffrey
Epstein Health, LLC., Woodcliff Lake, NJ, USA.
LUNGevity Foundation, Bethesda, MD, USA.
Patient Prefer Adherence. 2021 Feb 25;15:453-465. doi: 10.2147/PPA.S292462. eCollection 2021.
To evaluate which side effects of chemotherapy are considered most burdensome by patients with cancer, identify which health care professionals pay most attention to symptoms associated with chemotherapy-induced myelosuppression (CIM) from the patient perspective, and capture the "patient voice" describing how CIM impacts their daily lives.
Online survey of participants with breast, lung, or colorectal cancer who had received chemotherapy within the past 12 months and experienced ≥1 episode of CIM in the past year. Participants were asked to answer close-ended questions and provide qualitative responses to: "In your own words, please describe how side effects from myelosuppression have impacted your life."
Among 301 survey participants, fatigue was the most frequently reported side effect of chemotherapy; 55% of participants rated fatigue as highly bothersome (9 or 10 on a 1-10 scale of "bothersomeness"). Participants rated symptoms associated with CIM, including fatigue, weakened immune system (infections), bleeding and/or bruising, and shortness of breath, as being as bothersome as other side effects of chemotherapy, including alopecia, neuropathy, and nausea/vomiting. Overall, 24-43% of participants thought that CIM and its symptoms had a negative impact on their daily lives, including their ability to complete tasks at home and work, and to socialize. Qualitative responses supported these findings; participants highlighted that CIM-related symptoms, particularly fatigue and fear of infections, affected their ability to be physically active, complete work, or continue meaningful relationships with friends and family.
Participants described a real-world impact of CIM that often isolates them from family and friends, and means that they are unable to work or perform tasks of daily living. Using measures that help patients to recognize and communicate the signs and symptoms of CIM might increase the likelihood of maintaining daily lives as close to normal as possible, during and after chemotherapy treatment.
评估癌症患者认为化疗的哪些副作用最难以承受,从患者角度确定哪些医护人员最关注与化疗引起的骨髓抑制(CIM)相关的症状,并获取描述CIM如何影响其日常生活的“患者声音”。
对过去12个月内接受过化疗且在过去一年中经历过≥1次CIM发作的乳腺癌、肺癌或结直肠癌患者进行在线调查。参与者被要求回答封闭式问题,并对“请用你自己的话描述骨髓抑制的副作用如何影响了你的生活”提供定性回答。
在301名调查参与者中,疲劳是最常报告的化疗副作用;55%的参与者将疲劳评为非常困扰(在1-10分的“困扰程度”量表上为9或10分)。参与者将与CIM相关的症状,包括疲劳、免疫系统减弱(感染)、出血和/或瘀伤以及呼吸急促,评为与化疗的其他副作用,包括脱发、神经病变和恶心/呕吐一样困扰。总体而言,24%-43%的参与者认为CIM及其症状对他们的日常生活有负面影响,包括他们在家和工作中完成任务以及社交的能力。定性回答支持了这些发现;参与者强调与CIM相关的症状,特别是疲劳和对感染的恐惧,影响了他们进行体育活动、完成工作或与朋友和家人维持有意义关系的能力。
参与者描述了CIM在现实世界中的影响,这种影响常常使他们与家人和朋友隔离,意味着他们无法工作或进行日常生活任务。采用有助于患者识别和传达CIM体征和症状的措施,可能会增加在化疗治疗期间和之后尽可能维持接近正常日常生活的可能性。