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Gastmeier K, Ihlenfeld A, Gastmeier A, Hirt G, Landschaft A, Wirz S. [Patient-reported outcomes in chronic diseases under treatment with cannabis medicines : Analysis of the results of the Copeia survey]. Schmerz 2024:10.1007/s00482-024-00802-4. [PMID: 38451340 DOI: 10.1007/s00482-024-00802-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 03/08/2024]
Abstract
BACKGROUND The survey of Copeia captured early 2022 patient-reported outcomes (PRO) in Germany under cannabis medicinal product (CAM) therapy, with particular attention to symptoms, symptom changes, indications, side effects, dosages, and cost bearers. GOAL This study investigated the question of whether associations emerge from the results that could play a role in the indication and treatment monitoring of CAM in chronically ill patients. MATERIALS AND METHODS A standardized questionnaire was administered online nationwide in dialogue form over a 15-week period to collect itemized symptoms and PRO. Recruitment was supported by pharmacies, prescribing physicians, and patient associations. Inclusion criteria included physician-prescribed CAM therapy. RESULTS AND DISCUSSION Of 1582 participants, 1030 data sets (65%) could be completely analyzed. There was a heterogeneous patient population, whose common feature was disease chronicity. The frequency distribution of symptoms showed a homogeneous pattern for the respective indications, in which the most frequent six (pain 71%, sleep disturbance 64%, stress/tension 52%, inner restlessness 52%, depressive mood 44% and muscle tension 43%) seem to have a special significance. According to subjective assessment, quality of life improved significantly in 84% of all participating patients. CONCLUSION A symptom matrix (SMX) composed of different symptoms seems to play a special role in CAM therapy to improve the quality of life of chronically ill patients, regardless of the underlying disease. The SMX could contribute to the identification of an indication and to targeted treatment monitoring.
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Affiliation(s)
- Knud Gastmeier
- Praxis für Spezialisierte Ambulante Palliativmedizin, Potsdam, Deutschland
| | | | - Anne Gastmeier
- Praxis für Lungenheilkunde und Allgemeinmedizin, Kleinmachnow, Deutschland
| | | | | | - Stefan Wirz
- Abteilung für Anästhesie, Intensivmedizin, Schmerzmedizin/Palliativmedizin - Zentrum für Schmerzmedizin, Weaningzentrum, Cura Krankenhaus - eine Betriebsstätte der GFO Kliniken Bonn, Schülgenstr. 15, 53604, Bad Honnef, Deutschland.
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Dossun C, Popescu BV, Antoni D. [Evaluation of quality of life: Clinical relevance for patient]. Cancer Radiother 2021; 25:576-583. [PMID: 34284968 DOI: 10.1016/j.canrad.2021.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 06/20/2021] [Indexed: 10/20/2022]
Abstract
The quality of life of patients and its evaluation remains one of the primordial objectives in oncology. Different methods and tools of evaluation of quality of life have been developed with the objective of having a global evaluation, throughout different aspects, be it physical, emotional, psychological or social. The quality of life questionnaires improve and simplify the reevaluation and follow-up of patients during clinical trials. Patient reported outcome measures (PROMs) are an evaluation of the quality of life as experienced by the patients (patient-reported-outcomes [PROs]) and allow for physicians a personalized treatment approach. In radiotherapy, PROMs are a useful tool for the follow-up of patients during or after treatment. The technological advances, notably in data collecting, but also in their integration and treatment with regard to artificial intelligence will allow integrating these evaluation tools in the management of patients in oncology.
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Affiliation(s)
- C Dossun
- Service de radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue AlbertCalmette, 67200 Strasbourg cedex, France
| | - B V Popescu
- Service de radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue AlbertCalmette, 67200 Strasbourg cedex, France
| | - D Antoni
- Service de radiothérapie, Institut de cancérologie Strasbourg Europe (ICANS), 17, rue AlbertCalmette, 67200 Strasbourg cedex, France.
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Koyama N, Matsumura C, Tahara Y, Sako M, Kurosawa H, Nomura T, Eguchi Y, Ohba K, Yano Y. Symptom clusters and their influence on prognosis using EORTC QLQ-C15-PAL scores in terminally ill patients with cancer. Support Care Cancer 2021; 30:135-143. [PMID: 34241700 PMCID: PMC8636418 DOI: 10.1007/s00520-021-06380-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/13/2021] [Indexed: 01/06/2023]
Abstract
Purpose The aims of the present study were to investigate the symptom clusters in terminally ill patients with cancer using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL), and to examine whether these symptom clusters influenced prognosis. Methods We analyzed data from 130 cancer patients hospitalized in the palliative care unit from June 2018 to December 2019 in an observational study. Principal component analysis was used to detect symptom clusters using the scored date of 14 items in the QLQ-C15-PAL, except for overall QOL, at the time of hospitalization. The influence of the existence of these symptom clusters and Palliative Performance Scale (PPS) on survival was analyzed by Cox proportional hazards regression analysis, and survival curves were compared between the groups with or without existing corresponding symptom clusters using the log-rank test. Results The following symptom clusters were identified: cluster 1 (pain, insomnia, emotional functioning), cluster 2 (dyspnea, appetite loss, fatigue, and nausea), and cluster 3 (physical functioning). Cronbach’s alpha values for the symptom clusters ranged from 0.72 to 0.82. An increased risk of death was significantly associated with the existence of cluster 2 and poor PPS (log-rank test, p = 0.016 and p < 0.001, respectively). Conclusion In terminally ill patients with cancer, three symptom clusters were detected based on QLQ-C15-PAL scores. Poor PPS and the presence of symptom cluster that includes dyspnea, appetite loss, fatigue, and nausea indicated poor prognosis.
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Affiliation(s)
- Nanako Koyama
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, 5 Nakauchi-choYamashina-ku, MisasagiKyoto, 607-8414, Japan
| | - Chikako Matsumura
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, 5 Nakauchi-choYamashina-ku, MisasagiKyoto, 607-8414, Japan
| | - Yuuna Tahara
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, 5 Nakauchi-choYamashina-ku, MisasagiKyoto, 607-8414, Japan
| | - Morito Sako
- Department of Pharmacy, Tachibana Medical Corporation Higashisumiyoshi-Morimoto Hospital, Osaka, Japan
| | - Hideo Kurosawa
- Department of Pharmacy, Tachibana Medical Corporation Higashisumiyoshi-Morimoto Hospital, Osaka, Japan
| | - Takehisa Nomura
- Department of Pharmacy, Tachibana Medical Corporation Higashisumiyoshi-Morimoto Hospital, Osaka, Japan
| | - Yuki Eguchi
- Palliative Care Unit, Tachibana Medical Corporation Higashisumiyoshi-Morimoto Hospital, Osaka, Japan
| | - Kazuki Ohba
- Department of Palliative Care, Tachibana Medical Corporation Higashisumiyoshi-Morimoto Hospital, Osaka, Japan
| | - Yoshitaka Yano
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, 5 Nakauchi-choYamashina-ku, MisasagiKyoto, 607-8414, Japan.
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Marques K, Alves C. Nursing diagnoses clusters: survival and comfort in oncology end-of-life care. Int J Palliat Nurs 2020; 26:444-450. [PMID: 33331212 DOI: 10.12968/ijpn.2020.26.8.444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Holistic care and nursing diagnoses are essential in end-of-life, since interventions based on these ensure greater patient comfort and quality of life. AIMS To identify clusters of nursing diagnoses and repercussions for patient comfort and survival. METHODS A prospective cohort of 66 end-of-life patients with cancer was examined. Diagnostic groupings were created based on the Kolcaba's theory of comfort. Pearson's chi-square test and Kaplan-Meier estimator were used to assess the relationship between clusters, comfort, and survival. FINDINGS Three diagnostic groups and 23 nurse diagnoses were used. The first and most prevalent diagnosis cluster was related to intestinal tract disorders and sleep. The second was related to neuropsychological characteristics and fatigue associated with lower survival, while the third cluster was related to functionality and perception, which was shown to be associated with less comfort. CONCLUSION The three clusters were significantly associated with comfort and survival.
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Affiliation(s)
- Karine Marques
- Student, Postgraduate Nursing Program, Campus Universitário Darcy Ribeiro, Brazil
| | - Cristine Alves
- Lecturer, Department of Nursing, University of Brasilia, Federal District, Brazil
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Pilz MJ, Aaronson NK, Arraras JI, Caocci G, Efficace F, Groenvold M, Holzner B, van Leeuwen M, Loth FLC, Petersen MA, Ramage J, Tomaszewski KA, Young T, Giesinger JM. Evaluating the Thresholds for Clinical Importance of the EORTC QLQ-C15-PAL in Patients Receiving Palliative Treatment. J Palliat Med 2020; 24:397-404. [PMID: 32835601 DOI: 10.1089/jpm.2020.0159] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: The EORTC QLQ-C15-PAL is a shortened version of the widely used EORTC QLQ-C30. This questionnaire was developed to measure the symptoms and functional health of patients receiving palliative care. Objective: To enhance clinical interpretability of the EORTC QLQ-C15-PAL, our aim was to evaluate the sensitivity and specificity of thresholds for clinical importance developed previously for the QLQ-C30 when applied to the QLQ-C15-PAL scales. Design: Cross-sectional observational study. Setting/Subjects: Patients with cancer receiving any type of palliative treatment. Measurement: Patients completed the EORTC QLQ-C15-PAL and anchor items on limitations, worries, and need for help for each of the health domains covered by the questionnaire. The anchor items were summarized in a binary criterion for clinical importance to calculate the sensitivity and specificity of the thresholds for clinical importance. Results: In total, 225 patients participated in the study (mean age 64.5 years). Patients were recruited from Austria, Italy, the Netherlands, Poland, Spain, and the United Kingdom. The thresholds for clinical importance for the QLQ-C15-PAL scales showed a median sensitivity of 0.88 (range: 0.82 for sleep disturbances to 1.00 for dyspnea) and a median specificity of 0.74 (range: 0.54 for dyspnea to 0.89 for constipation). Conclusion: The thresholds for clinical importance showed high sensitivity and mostly high specificity in identifying clinically important symptoms and functional health impairments as assessed by the QLQ-C15-PAL. These thresholds will facilitate interpretation of EORTC QLQ-C15-PAL scores in daily clinical practice and clinical research.
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Affiliation(s)
- Micha J Pilz
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Juan I Arraras
- Oncology Departments, Complejo Hospitalario of Navarre, Pamplona, Spain
| | - Giovanni Caocci
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italy
| | - Mogens Groenvold
- The Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Bernhard Holzner
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Marieke van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Fanny L C Loth
- Department of Psychosomatic Medicine and Psychotherapy, Simssee Clinic Bad Endorf, Bad Endorf, Germany
| | - Morten Aa Petersen
- The Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - John Ramage
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, United Kingdom
| | - Krzysztof A Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland.,Scanmed St. Raphael Hospital, Krakow, Poland
| | - Teresa Young
- Lynda Jackson Macmillan Centre, East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
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