Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: main results of a cluster preference randomised controlled trial



Rogers, Simon N, Allmark, Christine, Bekiroglu, Fazilet, Edwards, Rhiannon Tudor, Fabbroni, Gillon, Flavel, Robert, Highet, Victoria, Ho, Michael WS, Humphris, Gerald M, Jones, Terry M
et al (show 17 more authors) (2021) Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: main results of a cluster preference randomised controlled trial. EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, 278 (9). pp. 3435-3449.

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Abstract

<h4>Purpose</h4>The patient concerns inventory (PCI) is a prompt list allowing head and neck cancer (HNC) patients to discuss issues that otherwise might be overlooked. This trial evaluated the effectiveness of using the PCI at routine outpatient clinics for one year after treatment on health-related QOL (HRQOL).<h4>Methods</h4>A pragmatic cluster preference randomised control trial with 15 consultants, 8 'using' and 7 'not using' the PCI intervention. Patients treated with curative intent (all sites, disease stages, treatments) were eligible.<h4>Results</h4>Consultants saw a median (inter-quartile range) 16 (13-26) patients, with 140 PCI and 148 control patients. Of the pre-specified outcomes, the 12-month results for the mean University of Washington Quality of Life (UW-QOLv4) social-emotional subscale score suggested a small clinical effect of intervention of 4.6 units (95% CI 0.2, 9.0), p = 0.04 after full adjustment for pre-stated case-mix. Results for UW-QOLv4 overall quality of life being less than good at 12 months (primary outcome) also favoured the PCI with a risk ratio of 0.83 (95% CI 0.66, 1.06) and absolute risk 4.8% (- 2.9%, 12.9%) but without achieving statistical significance. Other non-a-priori analyses, including all 12 UWQOL domains and at consultant level also suggested better HRQOL with PCI. Consultation times were unaffected and the number of items selected decreased over time.<h4>Conclusion</h4>This novel trial supports the integration of the PCI approach into routine consultations as a simple low-cost means of benefiting HNC patients. It adds to a growing body of evidence supporting the use of patient prompt lists more generally.

Item Type: Article
Uncontrolled Keywords: Head and neck cancer, Patient concerns inventory, Quality of life, Patient-reported outcomes, Intervention, Randomised trial
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 09 Jul 2021 08:41
Last Modified: 18 Jan 2023 21:36
DOI: 10.1007/s00405-020-06533-3
Open Access URL: https://doi.org/10.1007/s00405-020-06533-3
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3129390