Trajectories of health‐related quality of life and symptom burden in patients with advanced cancer towards the end of life: Longitudinal results from the eQuiPe study

Background Support for health‐related quality of life (HRQOL) is an essential part of cancer care in the final stages of life, yet empirical guidance regarding HRQOL and symptom trajectories is lacking. Aim To assess the change in HRQOL and symptom burden in the last year of life in patients with ad...

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Veröffentlicht in:Cancer 2024-02, Vol.130 (4), p.609-617
Hauptverfasser: Versluis, Moyke A. J., Raijmakers, Natasja J. H., Baars, Arnold, Beuken‐van Everdingen, Marieke H. J., Graeff, Alexander, Hendriks, Mathijs P., Jong, Wouter K., Kloover, Jeroen S., Kuip, Evelien J. M., Mandigers, Caroline M. P. W., Sommeijer, Dirkje W., Linden, Yvette M., Poll‐Franse, Lonneke V.
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container_end_page 617
container_issue 4
container_start_page 609
container_title Cancer
container_volume 130
creator Versluis, Moyke A. J.
Raijmakers, Natasja J. H.
Baars, Arnold
Beuken‐van Everdingen, Marieke H. J.
Graeff, Alexander
Hendriks, Mathijs P.
Jong, Wouter K.
Kloover, Jeroen S.
Kuip, Evelien J. M.
Mandigers, Caroline M. P. W.
Sommeijer, Dirkje W.
Linden, Yvette M.
Poll‐Franse, Lonneke V.
description Background Support for health‐related quality of life (HRQOL) is an essential part of cancer care in the final stages of life, yet empirical guidance regarding HRQOL and symptom trajectories is lacking. Aim To assess the change in HRQOL and symptom burden in the last year of life in patients with advanced cancer and its association with health care–related factors, cancer‐specific treatment, and comorbidity. Methods A prospective, multicenter, observational study in patients with advanced cancer (eQuiPe). Three monthly questionnaires included European Organization for Research and Treatment of Cancer Quality of Life‐C30 and reported continuity of care. Multivariable mixed‐effects analysis was used to assess the association between HRQOL and health care–related factors. Results A total of 762 deceased patients were included with a mean age of 66 (SD, 10) years and 52% were male. The most common primary tumors were lung (29%), colorectal (20%), and breast cancer (13%). Mean overall HRQOL decreased in the last 9 months of life, with the greatest decrease in the last 3 months (β –16.2). Fatigue, pain, appetite loss, dyspnea, constipation, and nausea worsened significantly in the last year of life. Multimorbidity (β –7.5) and a better reported continuity of care (β 0.7) were both significantly associated with the trajectory of HRQOL. Conclusion Mean overall HRQOL begins to decline 9 months before death, highlighting the need for early identification and (re)assessment of different symptoms as aspects of HRQOL follow different trajectories. Multimorbidity and reported continuity of care may be associated with the trajectory of HRQOL. Longitudinal results from the eQuiPe study show that the mean health‐related quality of life begins to decline 9 months before death in patients with advanced cancer. Higher perceived continuity with care is associated with an attenuated decline in health‐related quality of life.
doi_str_mv 10.1002/cncr.35060
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J. ; Raijmakers, Natasja J. H. ; Baars, Arnold ; Beuken‐van Everdingen, Marieke H. J. ; Graeff, Alexander ; Hendriks, Mathijs P. ; Jong, Wouter K. ; Kloover, Jeroen S. ; Kuip, Evelien J. M. ; Mandigers, Caroline M. P. W. ; Sommeijer, Dirkje W. ; Linden, Yvette M. ; Poll‐Franse, Lonneke V.</creator><creatorcontrib>Versluis, Moyke A. J. ; Raijmakers, Natasja J. H. ; Baars, Arnold ; Beuken‐van Everdingen, Marieke H. J. ; Graeff, Alexander ; Hendriks, Mathijs P. ; Jong, Wouter K. ; Kloover, Jeroen S. ; Kuip, Evelien J. M. ; Mandigers, Caroline M. P. W. ; Sommeijer, Dirkje W. ; Linden, Yvette M. ; Poll‐Franse, Lonneke V.</creatorcontrib><description>Background Support for health‐related quality of life (HRQOL) is an essential part of cancer care in the final stages of life, yet empirical guidance regarding HRQOL and symptom trajectories is lacking. Aim To assess the change in HRQOL and symptom burden in the last year of life in patients with advanced cancer and its association with health care–related factors, cancer‐specific treatment, and comorbidity. Methods A prospective, multicenter, observational study in patients with advanced cancer (eQuiPe). Three monthly questionnaires included European Organization for Research and Treatment of Cancer Quality of Life‐C30 and reported continuity of care. Multivariable mixed‐effects analysis was used to assess the association between HRQOL and health care–related factors. Results A total of 762 deceased patients were included with a mean age of 66 (SD, 10) years and 52% were male. The most common primary tumors were lung (29%), colorectal (20%), and breast cancer (13%). Mean overall HRQOL decreased in the last 9 months of life, with the greatest decrease in the last 3 months (β –16.2). Fatigue, pain, appetite loss, dyspnea, constipation, and nausea worsened significantly in the last year of life. Multimorbidity (β –7.5) and a better reported continuity of care (β 0.7) were both significantly associated with the trajectory of HRQOL. Conclusion Mean overall HRQOL begins to decline 9 months before death, highlighting the need for early identification and (re)assessment of different symptoms as aspects of HRQOL follow different trajectories. Multimorbidity and reported continuity of care may be associated with the trajectory of HRQOL. Longitudinal results from the eQuiPe study show that the mean health‐related quality of life begins to decline 9 months before death in patients with advanced cancer. Higher perceived continuity with care is associated with an attenuated decline in health‐related quality of life.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.35060</identifier><identifier>PMID: 37831749</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>advanced cancer ; Appetite loss ; Breast cancer ; Cancer ; Comorbidity ; Constipation ; Continuity ; Continuity of care ; Dyspnea ; Empirical analysis ; End of life ; Health care ; longitudinal ; Observational studies ; palliative care ; Patients ; Quality of life ; Respiration ; Tumors</subject><ispartof>Cancer, 2024-02, Vol.130 (4), p.609-617</ispartof><rights>2023 American Cancer Society.</rights><rights>2024 American Cancer Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3570-2ee363a75f2137f300a46d3efab24666bf5b26e5ec9237b508a37c58a94ef64e3</citedby><cites>FETCH-LOGICAL-c3570-2ee363a75f2137f300a46d3efab24666bf5b26e5ec9237b508a37c58a94ef64e3</cites><orcidid>0000-0001-7908-294X ; 0000-0002-9003-6124 ; 0000-0001-6687-5393</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.35060$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.35060$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37831749$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Versluis, Moyke A. J.</creatorcontrib><creatorcontrib>Raijmakers, Natasja J. H.</creatorcontrib><creatorcontrib>Baars, Arnold</creatorcontrib><creatorcontrib>Beuken‐van Everdingen, Marieke H. J.</creatorcontrib><creatorcontrib>Graeff, Alexander</creatorcontrib><creatorcontrib>Hendriks, Mathijs P.</creatorcontrib><creatorcontrib>Jong, Wouter K.</creatorcontrib><creatorcontrib>Kloover, Jeroen S.</creatorcontrib><creatorcontrib>Kuip, Evelien J. M.</creatorcontrib><creatorcontrib>Mandigers, Caroline M. P. W.</creatorcontrib><creatorcontrib>Sommeijer, Dirkje W.</creatorcontrib><creatorcontrib>Linden, Yvette M.</creatorcontrib><creatorcontrib>Poll‐Franse, Lonneke V.</creatorcontrib><title>Trajectories of health‐related quality of life and symptom burden in patients with advanced cancer towards the end of life: Longitudinal results from the eQuiPe study</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background Support for health‐related quality of life (HRQOL) is an essential part of cancer care in the final stages of life, yet empirical guidance regarding HRQOL and symptom trajectories is lacking. Aim To assess the change in HRQOL and symptom burden in the last year of life in patients with advanced cancer and its association with health care–related factors, cancer‐specific treatment, and comorbidity. Methods A prospective, multicenter, observational study in patients with advanced cancer (eQuiPe). Three monthly questionnaires included European Organization for Research and Treatment of Cancer Quality of Life‐C30 and reported continuity of care. Multivariable mixed‐effects analysis was used to assess the association between HRQOL and health care–related factors. Results A total of 762 deceased patients were included with a mean age of 66 (SD, 10) years and 52% were male. The most common primary tumors were lung (29%), colorectal (20%), and breast cancer (13%). Mean overall HRQOL decreased in the last 9 months of life, with the greatest decrease in the last 3 months (β –16.2). Fatigue, pain, appetite loss, dyspnea, constipation, and nausea worsened significantly in the last year of life. Multimorbidity (β –7.5) and a better reported continuity of care (β 0.7) were both significantly associated with the trajectory of HRQOL. Conclusion Mean overall HRQOL begins to decline 9 months before death, highlighting the need for early identification and (re)assessment of different symptoms as aspects of HRQOL follow different trajectories. Multimorbidity and reported continuity of care may be associated with the trajectory of HRQOL. Longitudinal results from the eQuiPe study show that the mean health‐related quality of life begins to decline 9 months before death in patients with advanced cancer. 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J.</creator><creator>Raijmakers, Natasja J. H.</creator><creator>Baars, Arnold</creator><creator>Beuken‐van Everdingen, Marieke H. J.</creator><creator>Graeff, Alexander</creator><creator>Hendriks, Mathijs P.</creator><creator>Jong, Wouter K.</creator><creator>Kloover, Jeroen S.</creator><creator>Kuip, Evelien J. M.</creator><creator>Mandigers, Caroline M. P. 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J.</creatorcontrib><creatorcontrib>Raijmakers, Natasja J. H.</creatorcontrib><creatorcontrib>Baars, Arnold</creatorcontrib><creatorcontrib>Beuken‐van Everdingen, Marieke H. J.</creatorcontrib><creatorcontrib>Graeff, Alexander</creatorcontrib><creatorcontrib>Hendriks, Mathijs P.</creatorcontrib><creatorcontrib>Jong, Wouter K.</creatorcontrib><creatorcontrib>Kloover, Jeroen S.</creatorcontrib><creatorcontrib>Kuip, Evelien J. M.</creatorcontrib><creatorcontrib>Mandigers, Caroline M. P. W.</creatorcontrib><creatorcontrib>Sommeijer, Dirkje W.</creatorcontrib><creatorcontrib>Linden, Yvette M.</creatorcontrib><creatorcontrib>Poll‐Franse, Lonneke V.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Versluis, Moyke A. J.</au><au>Raijmakers, Natasja J. H.</au><au>Baars, Arnold</au><au>Beuken‐van Everdingen, Marieke H. J.</au><au>Graeff, Alexander</au><au>Hendriks, Mathijs P.</au><au>Jong, Wouter K.</au><au>Kloover, Jeroen S.</au><au>Kuip, Evelien J. M.</au><au>Mandigers, Caroline M. P. W.</au><au>Sommeijer, Dirkje W.</au><au>Linden, Yvette M.</au><au>Poll‐Franse, Lonneke V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trajectories of health‐related quality of life and symptom burden in patients with advanced cancer towards the end of life: Longitudinal results from the eQuiPe study</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2024-02-15</date><risdate>2024</risdate><volume>130</volume><issue>4</issue><spage>609</spage><epage>617</epage><pages>609-617</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background Support for health‐related quality of life (HRQOL) is an essential part of cancer care in the final stages of life, yet empirical guidance regarding HRQOL and symptom trajectories is lacking. Aim To assess the change in HRQOL and symptom burden in the last year of life in patients with advanced cancer and its association with health care–related factors, cancer‐specific treatment, and comorbidity. Methods A prospective, multicenter, observational study in patients with advanced cancer (eQuiPe). Three monthly questionnaires included European Organization for Research and Treatment of Cancer Quality of Life‐C30 and reported continuity of care. Multivariable mixed‐effects analysis was used to assess the association between HRQOL and health care–related factors. Results A total of 762 deceased patients were included with a mean age of 66 (SD, 10) years and 52% were male. The most common primary tumors were lung (29%), colorectal (20%), and breast cancer (13%). Mean overall HRQOL decreased in the last 9 months of life, with the greatest decrease in the last 3 months (β –16.2). Fatigue, pain, appetite loss, dyspnea, constipation, and nausea worsened significantly in the last year of life. Multimorbidity (β –7.5) and a better reported continuity of care (β 0.7) were both significantly associated with the trajectory of HRQOL. Conclusion Mean overall HRQOL begins to decline 9 months before death, highlighting the need for early identification and (re)assessment of different symptoms as aspects of HRQOL follow different trajectories. Multimorbidity and reported continuity of care may be associated with the trajectory of HRQOL. Longitudinal results from the eQuiPe study show that the mean health‐related quality of life begins to decline 9 months before death in patients with advanced cancer. Higher perceived continuity with care is associated with an attenuated decline in health‐related quality of life.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37831749</pmid><doi>10.1002/cncr.35060</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7908-294X</orcidid><orcidid>https://orcid.org/0000-0002-9003-6124</orcidid><orcidid>https://orcid.org/0000-0001-6687-5393</orcidid></addata></record>
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source Wiley Online Library Journals Frontfile Complete
subjects advanced cancer
Appetite loss
Breast cancer
Cancer
Comorbidity
Constipation
Continuity
Continuity of care
Dyspnea
Empirical analysis
End of life
Health care
longitudinal
Observational studies
palliative care
Patients
Quality of life
Respiration
Tumors
title Trajectories of health‐related quality of life and symptom burden in patients with advanced cancer towards the end of life: Longitudinal results from the eQuiPe study
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