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 trial

SIMON ROGERS*, Christine Allmark, Fazilet Bekiroglu, Rhiannon Tudor Edwards, Gillon Fabbroni, Robert Flavel, Victoria Highet, Michael W. S. Ho, Gerald M. Humphris, Terry M Jones, Owais Khattak, Jeffrey Lancaster, Christopher Loh, Derek Lowe, Cher Lowies, Dominic Macareavy, James Moor, T. K. Ong, Amit Prasai, Nicholas RolandCherith Semple, Llinos Spencer, Sankalap Tandon, Steven Thomas, Andrew Schache, Richard Shaw, Anastasios Kanatas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Purpose: 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).
Methods: 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.
Results: 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.
Conclusion: 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.
Original languageEnglish
Pages (from-to)1-15
JournalEuropean Archives of Oto-Rhino-Laryngology
Early online date21 Dec 2020
DOIs
Publication statusE-pub ahead of print - 21 Dec 2020

Keywords

  • Head and Neck Cancer
  • Patient concerns inventory
  • Quality of Life
  • Patient Reported Outcomes
  • Intervention
  • Randomised Trial

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