The Use and Impact of Quality of Life Assessment Tools in Clinical Care Settings for Cancer Patients, with a Particular Emphasis on Brain Cancer: Insights from a Systematic Review and Stakeholder Consultations
15 Apr 2016
Are Quality of Life Measures Used in Care or Treatment of Brain Cancer Patients?
Fotolia
Summary
Quality of life considerations are important for all cancer treatment, especially when survival prospects are limited. Policy, health and research professionals and patient communities need to strengthen information exchange, raise awareness and provide training on the design, use and interpretation of tools that measure quality of life.
Background
The nature of evidence underpinning healthcare decision making is changing. The importance of reflecting patient views and measuring not only the clinical outcomes of cancer treatments, but also the more subjective impact on patient’s quality of life, is increasingly being recognised across the healthcare sector.
Quality of Life measurement tools generally take the form of questionnaires, which are used to measure the patient’s point of view on one or more of aspects of their quality of life. Such tools may help provide more comprehensive evidence on the effects of treatment and care decisions on a patient’s physical, psychological and social functioning. In a cancer context, although quality of life considerations are important for all cancers, they may be particularly important when survival prospects are limited.
Following the award of an educational grant by Roche, RAND Europe explored how Quality of Life measures are being used in the treatment and care of patients with brain cancer, and the implications for future policy and practice.
Goals
The research team explored the following:
- whether, when and how Quality of Life assessment tools are used in the treatment and care of patients with cancer, with particular (though not exclusive) emphasis on brain cancer
- which Quality of Life measurement tools are used (and if they are not used, why not); and
- implications for future research and policy
Methods
The team conducted a systematic review of the literature following guidance produced by the Centre for Reviews and Dissemination (CRD). The findings from the systematic review were then complemented with a series of stakeholder interviews to add more nuance and explanatory detail and to inform a future research and policy agenda.
Findings
- Quality of Life assessment tools are not currently routinely used in clinical practice in oncology, although they are used more frequently in in clinical trials.
- Evidence from the literature suggests some impacts on patient-physician communication from using Quality of Life tools, but evidence of the impact on clinical decisions was inconclusive.
- The interviews identified unharnessed potential and growing interest in the use of Quality of Life tools, but also a range of associated challenges that need to be addressed to facilitate more widespread uptake and impact.
- Interview evidence identified key factors that influence the extent to which Quality of Life issues are systematically considered in cancer care. These span the health-system factors, issues related to the type of tool used, the type and stage of cancer, the patient profile and data-related factors.
Recommendations
- The research identified a need for policy, health and research professionals and patient communities to strengthen information exchange, support awareness raising and provide training on the design, use and interpretation of the Quality of Life tools.
- The research also identified a need for further research and stakeholder engagement on how Quality of Life tools can achieve most impact across cancer and patient contexts.
