Changes in Patient-Reported Health Status in Advanced Cancer Patients from a Symptom Management Clinic: A Longitudinal Study Conducted in China

Yening Zhang; Zimeng Li; Ying Pang; Yi He; Shuangzhi He; Zhongge Su; Yuhe Zhou; Yan Wang; Bingmei Wang; Lili Song; Jinjiang Li; Xinkun Han; Chengcheng Zhou; Xiumin Li; Lili Tang

doi:10.1155/2022/7531545

Changes in Patient-Reported Health Status in Advanced Cancer Patients from a Symptom Management Clinic: A Longitudinal Study Conducted in China

J Oncol. 2022 Sep 16:2022:7531545. doi: 10.1155/2022/7531545. eCollection 2022.

Authors

Yening Zhang¹, Zimeng Li¹, Ying Pang¹, Yi He¹, Shuangzhi He¹, Zhongge Su¹, Yuhe Zhou¹, Yan Wang¹, Bingmei Wang¹, Lili Song¹, Jinjiang Li¹, Xinkun Han¹, Chengcheng Zhou¹, Xiumin Li¹, Lili Tang¹

Affiliation

¹ Department of Psycho-Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.

Abstract

Objectives: The integration of patient-reported health status has been increasingly emphasised for delivering high-quality care to advanced cancer patients. This research is designed to track health status changes over time in Chinese advanced cancer patients to explore the risk factors affecting their health status.

Methods: Advanced cancer patients were recruited from Peking University Cancer Hospital. An electronic patient-reported outcome (ePRO) system with validated measurements was used to collect the data. ANOVA, the chi-square test, the nonparametric Kruskal-Wallis H test, and generalized estimating equation (GEE) analysis were used for the data analysis.

Results: One hundred and three patients completed a baseline survey (T = 0) and two follow-up surveys (T1 = 14 days, T2 = 28 days). Chi-square test results indicate a significant decrease in the percentage of patients reporting moderate or severe difficulty experienced by patients in terms of mobility, pain/discomfort, and anxiety/depression. However, there is a significant increase in the percentage of patients reporting moderate or severe difficulty in self-care and usual activities. Scores on the visual analogue scale in the EQ-5D-5L instrument (EQ-VAS) are associated with patients' income, and the degree of moderate or severe anxiety/depression is found to be associated with employment status. The GEE results show that pain, loss of appetite, poor walking status effected by symptoms, depression, and anxiety has worsened the health status.

Conclusions: The health status of Chinese advanced cancer patients under ePRO follow-up in China significantly improves in the physical and psychological dimensions, accompanied by a decrease in usual activities and self-care. Routine screening and rational supportive care are recommended in oncology for cancer care. Based on the rational application of ePRO, longitudinal studies exploring the potential mechanisms of health status changing would provide more beneficial guidance for improving the quality of life in patients with advanced cancer.