Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement
Background Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life. Aims We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients’ future quality of life and whether these predictions are...
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| Veröffentlicht in: | Psycho-oncology (Chichester, England) England), 2022-06, Vol.31 (6), p.978-984 |
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| creator | Hoerger, Michael Gramling, Robert Epstein, Ronald Fenton, Joshua J. Mohile, Supriya G. Kravitz, Richard L. Mossman, Brenna Prigerson, Holly G. Alonzi, Sarah Malhotra, Kirti Duberstein, Paul |
| description | Background
Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life.
Aims
We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients’ future quality of life and whether these predictions are prospectively associated with end‐of‐life care and bereavement.
Materials & Methods
We conducted secondary analyses of clinical trial data. Patients with advanced cancer (n = 156), caregivers (n = 156), and oncologists (n = 38) predicted patient quality of life 3 months into the future. Patients subsequently rated their quality of life 3 months later. Medical record data documented chemotherapy and emergency department (ED)/inpatient visits in the 30 days before death (n = 79 decedents). Caregivers self‐reported on depression, anxiety, grief, purpose, and regret 7‐months post‐mortem. In mixed‐effects models, patient, caregiver, and oncologist quality‐of‐life predictions at study entry were used to predict end‐of‐life care and caregiver outcomes, controlling for patients’ quality of life at 3‐month follow‐up, demographic and clinical characteristics, and nesting within oncologists.
Results
Caregivers (P < 0.0001) and oncologists (P = 0.001) predicted lower quality of life than what patients actually experienced. Among decedents, 24.0% received chemotherapy and 54.5% had an ED/inpatient visit. When caregivers’ predictions were more negative, patients were less likely to receive chemotherapy (P = 0.028) or have an ED/inpatient visit (P = 0.033), and caregivers reported worse depression (P = 0.002), anxiety (P = 0.019), and grief (P = 0.028) and less purpose in life (P |
| doi_str_mv | 10.1002/pon.5887 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2623892249</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2726021036</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3497-15acc1fe998327e133a75480c3f6a090593a808a951c19b1b3d1b0641cbb6d313</originalsourceid><addsrcrecordid>eNp1kctO3DAUhi3UCihU4gkqS92wIODLxInZIdQLEios6No6cU7AKGMPdjJodn2EvkPfrE9SZwaohMTG5yw-ff51fkIOODvmjImTRfDHZV1XW2SXM60Lrjh_N-1lVWgx0zvkQ0r3jGVYq22yI0tW11qoXfLnGgaHfjiiFiLeuiXGIwq-pcHb0Idblwa6iNg6O7jgEw0dfRihd8NqWnvXIXWeQrsEb7HNkjziKT2zdoxgV2sVpBSsg43g0Q13FH3799fv0OVnrZj-XqMvIWiDEWGJ85xtn7zvoE_48WnukZ9fv9ycfy8ur75dnJ9dFlbOdFXwEqzlHWpdS1EhlxKqclYzKzsFTLNSS6hZDbrkluuGN7LlDVMzbptGtZLLPXK48S5ieBgxDWbuksW-B49hTEYoIfPV8j0z-vkVeh_G6HM6IyqhmOBMqv9CG0NKETuziG4OcWU4M1NxJhdnpuIy-ulJODZzbF_A56YyUGyAR9fj6k2Rub76sRb-A8EmpTM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2726021036</pqid></control><display><type>article</type><title>Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Hoerger, Michael ; Gramling, Robert ; Epstein, Ronald ; Fenton, Joshua J. ; Mohile, Supriya G. ; Kravitz, Richard L. ; Mossman, Brenna ; Prigerson, Holly G. ; Alonzi, Sarah ; Malhotra, Kirti ; Duberstein, Paul</creator><creatorcontrib>Hoerger, Michael ; Gramling, Robert ; Epstein, Ronald ; Fenton, Joshua J. ; Mohile, Supriya G. ; Kravitz, Richard L. ; Mossman, Brenna ; Prigerson, Holly G. ; Alonzi, Sarah ; Malhotra, Kirti ; Duberstein, Paul</creatorcontrib><description>Background
Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life.
Aims
We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients’ future quality of life and whether these predictions are prospectively associated with end‐of‐life care and bereavement.
Materials & Methods
We conducted secondary analyses of clinical trial data. Patients with advanced cancer (n = 156), caregivers (n = 156), and oncologists (n = 38) predicted patient quality of life 3 months into the future. Patients subsequently rated their quality of life 3 months later. Medical record data documented chemotherapy and emergency department (ED)/inpatient visits in the 30 days before death (n = 79 decedents). Caregivers self‐reported on depression, anxiety, grief, purpose, and regret 7‐months post‐mortem. In mixed‐effects models, patient, caregiver, and oncologist quality‐of‐life predictions at study entry were used to predict end‐of‐life care and caregiver outcomes, controlling for patients’ quality of life at 3‐month follow‐up, demographic and clinical characteristics, and nesting within oncologists.
Results
Caregivers (P < 0.0001) and oncologists (P = 0.001) predicted lower quality of life than what patients actually experienced. Among decedents, 24.0% received chemotherapy and 54.5% had an ED/inpatient visit. When caregivers’ predictions were more negative, patients were less likely to receive chemotherapy (P = 0.028) or have an ED/inpatient visit (P = 0.033), and caregivers reported worse depression (P = 0.002), anxiety (P = 0.019), and grief (P = 0.028) and less purpose in life (P < 0.001) 7‐months post‐mortem.
Conclusion
When caregivers have more negative expectations about patients’ quality of life, patients receive less intensive end‐of‐life care, and caregivers report worse bereavement outcomes.</description><identifier>ISSN: 1057-9249</identifier><identifier>EISSN: 1099-1611</identifier><identifier>DOI: 10.1002/pon.5887</identifier><identifier>PMID: 35088926</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Accuracy ; affective forecasting ; Anxiety ; Bereavement ; Cancer ; Caregivers ; Chemotherapy ; Clinical research ; Clinical trials ; Demography ; Emergency services ; end‐of‐life ; Grief ; Health psychology ; Humans ; Inpatient care ; Medical prognosis ; Mental depression ; Neoplasms - therapy ; Oncologists ; Oncology ; Patients ; prognostication ; psycho‐oncology ; Purpose in life ; Quality of Life ; Regret ; Terminal Care</subject><ispartof>Psycho-oncology (Chichester, England), 2022-06, Vol.31 (6), p.978-984</ispartof><rights>2022 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3497-15acc1fe998327e133a75480c3f6a090593a808a951c19b1b3d1b0641cbb6d313</citedby><cites>FETCH-LOGICAL-c3497-15acc1fe998327e133a75480c3f6a090593a808a951c19b1b3d1b0641cbb6d313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpon.5887$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpon.5887$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,30976,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35088926$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoerger, Michael</creatorcontrib><creatorcontrib>Gramling, Robert</creatorcontrib><creatorcontrib>Epstein, Ronald</creatorcontrib><creatorcontrib>Fenton, Joshua J.</creatorcontrib><creatorcontrib>Mohile, Supriya G.</creatorcontrib><creatorcontrib>Kravitz, Richard L.</creatorcontrib><creatorcontrib>Mossman, Brenna</creatorcontrib><creatorcontrib>Prigerson, Holly G.</creatorcontrib><creatorcontrib>Alonzi, Sarah</creatorcontrib><creatorcontrib>Malhotra, Kirti</creatorcontrib><creatorcontrib>Duberstein, Paul</creatorcontrib><title>Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement</title><title>Psycho-oncology (Chichester, England)</title><addtitle>Psychooncology</addtitle><description>Background
Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life.
Aims
We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients’ future quality of life and whether these predictions are prospectively associated with end‐of‐life care and bereavement.
Materials & Methods
We conducted secondary analyses of clinical trial data. Patients with advanced cancer (n = 156), caregivers (n = 156), and oncologists (n = 38) predicted patient quality of life 3 months into the future. Patients subsequently rated their quality of life 3 months later. Medical record data documented chemotherapy and emergency department (ED)/inpatient visits in the 30 days before death (n = 79 decedents). Caregivers self‐reported on depression, anxiety, grief, purpose, and regret 7‐months post‐mortem. In mixed‐effects models, patient, caregiver, and oncologist quality‐of‐life predictions at study entry were used to predict end‐of‐life care and caregiver outcomes, controlling for patients’ quality of life at 3‐month follow‐up, demographic and clinical characteristics, and nesting within oncologists.
Results
Caregivers (P < 0.0001) and oncologists (P = 0.001) predicted lower quality of life than what patients actually experienced. Among decedents, 24.0% received chemotherapy and 54.5% had an ED/inpatient visit. When caregivers’ predictions were more negative, patients were less likely to receive chemotherapy (P = 0.028) or have an ED/inpatient visit (P = 0.033), and caregivers reported worse depression (P = 0.002), anxiety (P = 0.019), and grief (P = 0.028) and less purpose in life (P < 0.001) 7‐months post‐mortem.
Conclusion
When caregivers have more negative expectations about patients’ quality of life, patients receive less intensive end‐of‐life care, and caregivers report worse bereavement outcomes.</description><subject>Accuracy</subject><subject>affective forecasting</subject><subject>Anxiety</subject><subject>Bereavement</subject><subject>Cancer</subject><subject>Caregivers</subject><subject>Chemotherapy</subject><subject>Clinical research</subject><subject>Clinical trials</subject><subject>Demography</subject><subject>Emergency services</subject><subject>end‐of‐life</subject><subject>Grief</subject><subject>Health psychology</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Medical prognosis</subject><subject>Mental depression</subject><subject>Neoplasms - therapy</subject><subject>Oncologists</subject><subject>Oncology</subject><subject>Patients</subject><subject>prognostication</subject><subject>psycho‐oncology</subject><subject>Purpose in life</subject><subject>Quality of Life</subject><subject>Regret</subject><subject>Terminal Care</subject><issn>1057-9249</issn><issn>1099-1611</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kctO3DAUhi3UCihU4gkqS92wIODLxInZIdQLEios6No6cU7AKGMPdjJodn2EvkPfrE9SZwaohMTG5yw-ff51fkIOODvmjImTRfDHZV1XW2SXM60Lrjh_N-1lVWgx0zvkQ0r3jGVYq22yI0tW11qoXfLnGgaHfjiiFiLeuiXGIwq-pcHb0Idblwa6iNg6O7jgEw0dfRihd8NqWnvXIXWeQrsEb7HNkjziKT2zdoxgV2sVpBSsg43g0Q13FH3799fv0OVnrZj-XqMvIWiDEWGJ85xtn7zvoE_48WnukZ9fv9ycfy8ur75dnJ9dFlbOdFXwEqzlHWpdS1EhlxKqclYzKzsFTLNSS6hZDbrkluuGN7LlDVMzbptGtZLLPXK48S5ieBgxDWbuksW-B49hTEYoIfPV8j0z-vkVeh_G6HM6IyqhmOBMqv9CG0NKETuziG4OcWU4M1NxJhdnpuIy-ulJODZzbF_A56YyUGyAR9fj6k2Rub76sRb-A8EmpTM</recordid><startdate>202206</startdate><enddate>202206</enddate><creator>Hoerger, Michael</creator><creator>Gramling, Robert</creator><creator>Epstein, Ronald</creator><creator>Fenton, Joshua J.</creator><creator>Mohile, Supriya G.</creator><creator>Kravitz, Richard L.</creator><creator>Mossman, Brenna</creator><creator>Prigerson, Holly G.</creator><creator>Alonzi, Sarah</creator><creator>Malhotra, Kirti</creator><creator>Duberstein, Paul</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>202206</creationdate><title>Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement</title><author>Hoerger, Michael ; Gramling, Robert ; Epstein, Ronald ; Fenton, Joshua J. ; Mohile, Supriya G. ; Kravitz, Richard L. ; Mossman, Brenna ; Prigerson, Holly G. ; Alonzi, Sarah ; Malhotra, Kirti ; Duberstein, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3497-15acc1fe998327e133a75480c3f6a090593a808a951c19b1b3d1b0641cbb6d313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Accuracy</topic><topic>affective forecasting</topic><topic>Anxiety</topic><topic>Bereavement</topic><topic>Cancer</topic><topic>Caregivers</topic><topic>Chemotherapy</topic><topic>Clinical research</topic><topic>Clinical trials</topic><topic>Demography</topic><topic>Emergency services</topic><topic>end‐of‐life</topic><topic>Grief</topic><topic>Health psychology</topic><topic>Humans</topic><topic>Inpatient care</topic><topic>Medical prognosis</topic><topic>Mental depression</topic><topic>Neoplasms - therapy</topic><topic>Oncologists</topic><topic>Oncology</topic><topic>Patients</topic><topic>prognostication</topic><topic>psycho‐oncology</topic><topic>Purpose in life</topic><topic>Quality of Life</topic><topic>Regret</topic><topic>Terminal Care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoerger, Michael</creatorcontrib><creatorcontrib>Gramling, Robert</creatorcontrib><creatorcontrib>Epstein, Ronald</creatorcontrib><creatorcontrib>Fenton, Joshua J.</creatorcontrib><creatorcontrib>Mohile, Supriya G.</creatorcontrib><creatorcontrib>Kravitz, Richard L.</creatorcontrib><creatorcontrib>Mossman, Brenna</creatorcontrib><creatorcontrib>Prigerson, Holly G.</creatorcontrib><creatorcontrib>Alonzi, Sarah</creatorcontrib><creatorcontrib>Malhotra, Kirti</creatorcontrib><creatorcontrib>Duberstein, Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Psycho-oncology (Chichester, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoerger, Michael</au><au>Gramling, Robert</au><au>Epstein, Ronald</au><au>Fenton, Joshua J.</au><au>Mohile, Supriya G.</au><au>Kravitz, Richard L.</au><au>Mossman, Brenna</au><au>Prigerson, Holly G.</au><au>Alonzi, Sarah</au><au>Malhotra, Kirti</au><au>Duberstein, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement</atitle><jtitle>Psycho-oncology (Chichester, England)</jtitle><addtitle>Psychooncology</addtitle><date>2022-06</date><risdate>2022</risdate><volume>31</volume><issue>6</issue><spage>978</spage><epage>984</epage><pages>978-984</pages><issn>1057-9249</issn><eissn>1099-1611</eissn><abstract>Background
Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life.
Aims
We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients’ future quality of life and whether these predictions are prospectively associated with end‐of‐life care and bereavement.
Materials & Methods
We conducted secondary analyses of clinical trial data. Patients with advanced cancer (n = 156), caregivers (n = 156), and oncologists (n = 38) predicted patient quality of life 3 months into the future. Patients subsequently rated their quality of life 3 months later. Medical record data documented chemotherapy and emergency department (ED)/inpatient visits in the 30 days before death (n = 79 decedents). Caregivers self‐reported on depression, anxiety, grief, purpose, and regret 7‐months post‐mortem. In mixed‐effects models, patient, caregiver, and oncologist quality‐of‐life predictions at study entry were used to predict end‐of‐life care and caregiver outcomes, controlling for patients’ quality of life at 3‐month follow‐up, demographic and clinical characteristics, and nesting within oncologists.
Results
Caregivers (P < 0.0001) and oncologists (P = 0.001) predicted lower quality of life than what patients actually experienced. Among decedents, 24.0% received chemotherapy and 54.5% had an ED/inpatient visit. When caregivers’ predictions were more negative, patients were less likely to receive chemotherapy (P = 0.028) or have an ED/inpatient visit (P = 0.033), and caregivers reported worse depression (P = 0.002), anxiety (P = 0.019), and grief (P = 0.028) and less purpose in life (P < 0.001) 7‐months post‐mortem.
Conclusion
When caregivers have more negative expectations about patients’ quality of life, patients receive less intensive end‐of‐life care, and caregivers report worse bereavement outcomes.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35088926</pmid><doi>10.1002/pon.5887</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1057-9249 |
| ispartof | Psycho-oncology (Chichester, England), 2022-06, Vol.31 (6), p.978-984 |
| issn | 1057-9249 1099-1611 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Accuracy affective forecasting Anxiety Bereavement Cancer Caregivers Chemotherapy Clinical research Clinical trials Demography Emergency services end‐of‐life Grief Health psychology Humans Inpatient care Medical prognosis Mental depression Neoplasms - therapy Oncologists Oncology Patients prognostication psycho‐oncology Purpose in life Quality of Life Regret Terminal Care |
| title | Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement |
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