Contributions
Type: Oral Presentation
Presentation during EHA20: From 12.06.2015 11:30 to 12.06.2015 11:45
Location: Room Stolz 2
Background
Patients’ Health-Related Quality of Life (HRQoL) is important, particularly in the relapsed/refractory multiple myeloma (RRMM) setting. Exploring levels of concordance between physicians’ and patients’ perceptions of HRQoL could improve physicians’ understanding of patients’ feelings and help in daily patient management. Findings of our study previously published for the overall population showed no major discordance between ratings of HRQoL/functioning domains, but major discordance between the perceptions of physicians and patients for symptom domains.
Aims
To compare between countries the difference in physicians’ and patients’ perceptions of HRQoL and symptoms.
Methods
An observational study was conducted in Italy, Germany, France, UK/Ireland and Belgium in RRMM patients starting 2nd or 3rd line treatment. Patients and physicians completed three EORTC questionnaires: Quality-of-Life Core Questionnaire (QLQ-C30), with 15 domains (Global Health Status/QOL, Physical Functioning, Role Functioning, Emotional Functioning, Cognitive Functioning, Social Functioning, Fatigue, Nausea and Vomiting, Pain, Dyspnea, Insomnia, Appetite Loss, Constipation, Diarrhea and Financial Difficulties); QLQ-Multiple Myeloma (QLQ-MY20), with four domains (Disease Symptoms, Side-Effects of Treatment, Body Image and Future Perspective); QLQ-Chemotherapy-Induced Peripheral Neuropathy (QLQ-CIPN20) with three domains (Sensory scale, Motor scale and Autonomic scale). Intra Correlation Coefficients (ICC) were calculated to compare patient and physician scores (ICC<0.40 showing major discordance). The difference in patient and physician scores was compared across countries using ANOVA.
Results
The population included 33 physicians who enrolled 258 patients (mean age=70; 54% male; mean time since diagnosis=3 years). At baseline, 251 (97%) sets of EORTC questionnaires were completed by patients and 252 (98%) by physicians.
Based on ICC (Table 1), most of the domains with major discordance observed between patients and physicians were symptom domains, in all countries but Italy. In almost all cases, physicians underestimated the level of symptoms experienced by their patients. However, major discordance was not observed on the same symptom domains across countries. The number of domains showing major discordance also differed, ranging from none (Italian sites) to nine (UK/Irish sites). Variations across countries were observed on the level of patient-physician discordance, with statistical significance reached for four out of 14 symptom domains.
For HRQoL/functioning domains, major patient-physician discordance was also not observed on the same domains across countries. Furthermore, the number of domains showing major discordance differed, ranging from none (French sites) to five (Belgian sites). Depending on domain and country, physicians either underestimated or overestimated their patients’ HRQoL/functioning. Variations across countries were observed on the level of patient-physician discordance, with statistical significance reached for six out of eight domains. The highest variations (p<0.001) were observed for Physical Functioning, Social Functioning, Pain and Future Perspective domains.
Summary
Major discordance was observed across countries on symptom domains, with physicians consistently underestimating their patient’s symptoms. However, the specific symptom domains concerned varied between countries. An even more variable picture was observed for HRQoL/functioning domains. This supports the importance to also consider patients’ view of their own health.
Keyword(s): Multiple myeloma, Patient, Quality of life
Session topic: Quality of life and health economics
Type: Oral Presentation
Presentation during EHA20: From 12.06.2015 11:30 to 12.06.2015 11:45
Location: Room Stolz 2
Background
Patients’ Health-Related Quality of Life (HRQoL) is important, particularly in the relapsed/refractory multiple myeloma (RRMM) setting. Exploring levels of concordance between physicians’ and patients’ perceptions of HRQoL could improve physicians’ understanding of patients’ feelings and help in daily patient management. Findings of our study previously published for the overall population showed no major discordance between ratings of HRQoL/functioning domains, but major discordance between the perceptions of physicians and patients for symptom domains.
Aims
To compare between countries the difference in physicians’ and patients’ perceptions of HRQoL and symptoms.
Methods
An observational study was conducted in Italy, Germany, France, UK/Ireland and Belgium in RRMM patients starting 2nd or 3rd line treatment. Patients and physicians completed three EORTC questionnaires: Quality-of-Life Core Questionnaire (QLQ-C30), with 15 domains (Global Health Status/QOL, Physical Functioning, Role Functioning, Emotional Functioning, Cognitive Functioning, Social Functioning, Fatigue, Nausea and Vomiting, Pain, Dyspnea, Insomnia, Appetite Loss, Constipation, Diarrhea and Financial Difficulties); QLQ-Multiple Myeloma (QLQ-MY20), with four domains (Disease Symptoms, Side-Effects of Treatment, Body Image and Future Perspective); QLQ-Chemotherapy-Induced Peripheral Neuropathy (QLQ-CIPN20) with three domains (Sensory scale, Motor scale and Autonomic scale). Intra Correlation Coefficients (ICC) were calculated to compare patient and physician scores (ICC<0.40 showing major discordance). The difference in patient and physician scores was compared across countries using ANOVA.
Results
The population included 33 physicians who enrolled 258 patients (mean age=70; 54% male; mean time since diagnosis=3 years). At baseline, 251 (97%) sets of EORTC questionnaires were completed by patients and 252 (98%) by physicians.
Based on ICC (Table 1), most of the domains with major discordance observed between patients and physicians were symptom domains, in all countries but Italy. In almost all cases, physicians underestimated the level of symptoms experienced by their patients. However, major discordance was not observed on the same symptom domains across countries. The number of domains showing major discordance also differed, ranging from none (Italian sites) to nine (UK/Irish sites). Variations across countries were observed on the level of patient-physician discordance, with statistical significance reached for four out of 14 symptom domains.
For HRQoL/functioning domains, major patient-physician discordance was also not observed on the same domains across countries. Furthermore, the number of domains showing major discordance differed, ranging from none (French sites) to five (Belgian sites). Depending on domain and country, physicians either underestimated or overestimated their patients’ HRQoL/functioning. Variations across countries were observed on the level of patient-physician discordance, with statistical significance reached for six out of eight domains. The highest variations (p<0.001) were observed for Physical Functioning, Social Functioning, Pain and Future Perspective domains.
Summary
Major discordance was observed across countries on symptom domains, with physicians consistently underestimating their patient’s symptoms. However, the specific symptom domains concerned varied between countries. An even more variable picture was observed for HRQoL/functioning domains. This supports the importance to also consider patients’ view of their own health.
Keyword(s): Multiple myeloma, Patient, Quality of life
Session topic: Quality of life and health economics