Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients : main results of a cluster preference randomised controlled trial
Abstract
Purpose The patient concerns inventory (PCI) is a prompt list allowing head and neck cancer (HNC) patients to discuss issues that otherwise might be overlooked. This trial evaluated the effectiveness of using the PCI at routine outpatient clinics for one year after treatment on health-related QOL (HRQOL). Methods A pragmatic cluster preference randomised control trial with 15 consultants, 8 ‘using’ and 7 ‘not using’ the PCI intervention. Patients treated with curative intent (all sites, disease stages, treatments) were eligible. Results Consultants saw a median (inter-quartile range) 16 (13–26) patients, with 140 PCI and 148 control patients. Of the pre-specified outcomes, the 12-month results for the mean University of Washington Quality of Life (UW-QOLv4) social-emotional subscale score suggested a small clinical effect of intervention of 4.6 units (95% CI 0.2, 9.0), p = 0.04 after full adjustment for pre-stated case-mix. Results for UW-QOLv4 overall quality of life being less than good at 12 months (primary outcome) also favoured the PCI with a risk ratio of 0.83 (95% CI 0.66, 1.06) and absolute risk 4.8% (− 2.9%, 12.9%) but without achieving statistical significance. Other non-a-priori analyses, including all 12 UWQOL domains and at consultant level also suggested better HRQOL with PCI. Consultation times were unaffected and the number of items selected decreased over time. Conclusion This novel trial supports the integration of the PCI approach into routine consultations as a simple low-cost means of benefiting HNC patients. It adds to a growing body of evidence supporting the use of patient prompt lists more generally.
Citation
Rogers , S N , Allmark , C , Bekiroglu , F , Edwards , R T , Fabbroni , G , Flavel , R , Highet , V , Ho , M WS , Humphris , G M , Jones , T M , Khattak , O , Lancaster , J , Loh , C , Lowe , D , Lowies , C , Macareavy , D , Moor , J , Ong , T K , Prasai , A , Roland , N , Semple , C , Spencer , L H , Tandon , S , Thomas , S J , Schache , A , Shaw , R J & Kanatas , A 2020 , ' Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients : main results of a cluster preference randomised controlled trial ' , European Archives of Oto-Rhino-Laryngology . https://doi.org/10.1007/s00405-020-06533-3
Publication
European Archives of Oto-Rhino-Laryngology
Status
Peer reviewed
ISSN
0937-4477Type
Journal article
Rights
Copyright © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Description
Funding: UK National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0215-36047).Collections
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