Association of financial toxicity (FT) with depression, anxiety, and quality of life (QoL) in older patients with advanced cancer: An analysis of 544 patients from 31 practices in the University of Rochester NCI Community Oncology Research Program (UR NCORP).

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e22037-e22037 ◽  
Author(s):  
Asad Arastu ◽  
Joseph Ciminelli ◽  
Eva Culakova ◽  
Lianlian Lei ◽  
Huiwen Xu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Research Program ◽  
Older Patients ◽  
Financial Toxicity ◽  
Oncology Research ◽  
Community Oncology ◽  
The University

The impact of financial toxicity on quality of life in older patients with cancer: Baseline data from the University of Rochester NCI Community Oncology Research Program (NCORP).

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 87-87
Author(s):  
Asad Arastu ◽  
Joseph Ciminelli ◽  
Eva Culakova ◽  
Lianlian Lei ◽  
Huiwen Xu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Cancer Care ◽  
Depression Scale ◽  
Baseline Data ◽  
Financial Toxicity ◽  
Oncology Research ◽  
Anxiety Depression ◽  
The Impact

87 Background: Financial toxicity (FT), or the stress and strain patients (pts) experience as a result of paying for cancer care, can have profound negative impacts on pts’ overall quality of life (QoL). This study examined associations of FT with anxiety, depression, and QoL in older pts with advanced cancer. Methods: This is a secondary analysis of baseline data from a Geriatric Assessment intervention study conducted by UR NCORP across 31 practice sites (PI: Mohile). Pts were categorized as experiencing FT if they reported any one of the following: delaying medications due to cost, insufficient income in a typical month for food and housing, or insufficient income in a typical month for other basic needs. Pts also completed the Generalized Anxiety Disorder-7 (GAD7, score 0-21) to evaluate anxiety, the Geriatric Depression Scale (GDS, score 0-15) to assess depression, and the Functional Assessment of Cancer Therapy- Generation (FACT-G, score 0-108), to measure overall QoL. Associations of FT with anxiety, depression, and QoL were assessed in separate multivariate linear regression models controlling for covariates at p < 0.1. Results: Among 542 pts (mean age 77; range 70-96, 49% female), 18% (98 pts) experienced FT. In separate regression analysis, FT was significantly associated with all 3 outcome measures. On average, pts experiencing FT scored 1.76 higher (p < 0.01) on the GAD7 (indicating greater anxiety severity), 0.76 points higher (p = 0.02) on the GDS (indicating greater depression severity), and 5.16 points lower (p < 0.01) on the FACT-G (indicating lower QoL). Conclusions: Older pts with advanced cancer who experience income and cost-related barriers to quality cancer care reported worse anxiety, depression, and QoL than those without FT. Given the association between FT and these outcomes, these 3 FT questions may help identify vulnerable older pts and allow providers to intervene sooner and thereby enhance the quality of care pts receive.

scholarly journals Quality of Life of Caregivers of Older Patients with Advanced Cancer

2019 ◽  
Vol 67 (5) ◽  
pp. 969-977 ◽  
Author(s):  
Lee A. Kehoe ◽  
Huiwen Xu ◽  
Paul Duberstein ◽  
Kah Poh Loh ◽  
Eva Culakova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Older Patients

A geriatric assessment (GA) intervention for older patients with advanced cancer: Secondary outcomes from a University of Rochester cancer center NCI community oncology research program cluster randomized controlled trial (CRCT).

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 33-33
Author(s):  
Supriya Gupta Mohile ◽  
Mostafa Mohamed ◽  
Huiwen Xu ◽  
Amita Patil ◽  
Eva Culakova ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Older Patients ◽  
Controlled Trial ◽  
Depression Scale ◽  
Cancer Center ◽  
Oncology Research ◽  
Community Oncology ◽  
Treatment Type ◽  
Patient Reported ◽  
Secondary Outcomes

33 Background: GA evaluates aging-related domains (e.g., function) known to be associated with cancer treatment toxicity. We found that providing a GA summary with management recommendations to oncologists reduces clinician-rated toxicity in older patients (pts) with advanced cancer receiving high risk treatment (presented @ASCO2020). Herein, we report secondary outcomes on the effects of the GA intervention on aging-related outcomes. Methods: Pts aged ≥ 70 with incurable solid tumors or lymphoma and ≥ 1 impaired GA domain starting a new treatment regimen were enrolled. Community oncology practices were randomized to intervention (oncologists received GA summary/recommendations) or usual care (none given). Secondary analyses examined effects of the intervention on functional outcomes (patient-reported falls, instrumental activities of daily living (IADL), short physical performance battery (SPPB), geriatric depression scale (GDS), and medications [total and prescription]). Outcomes were analyzed using linear mixed effects model, logistic or Poisson regression adjusted for baseline values, time, and site effects as appropriate. Results: From 2013-19, 718 pts were enrolled from 41 practices. Age (mean 77 yrs), sex (43% women), number of impaired GA domains (median 4/8), and treatment type (chemotherapy 88%) were not different by arm. More pts in intervention were black (12% vs 3%, p<0.01), had GI cancer (38% vs 31%, p<0.01), and had prior chemotherapy (31% vs 23%, p=0.02). Overall, 16.4% of all pts had one new fall over 3 months; patients in the intervention arm were significantly less like to fall over 3 months (11.7% vs 20.7%; Risk Ratio 0.58; 95% CI 0.40-0.84, p=0.004). There was no difference in the total number of medications (mean 5.86 vs 5.79, p=0.80) and prescriptions (mean 4.26 vs 4.20, p=0.70) at baseline. More medications (adjusted mean 0.23 vs 0.09, p=0.03) and prescriptions (0.19 vs 0.07, p=0.05) were discontinued during intervention, although there was no difference at 3 month follow up. There were no significant between-arms differences in IADL, SPPB, and GDS. Conclusions: Providing GA information to oncologists reduces the proportion of older pts who experience a fall over 3 months and improves polypharmacy; both of these endpoints are of clinical importance to older adults with aging-related conditions and advanced cancer undergoing palliative treatment. Funding: R01CA177592, U01CA233167, UG1CA189961. Clinical trial information: NCT02054741 .

Overview of the Tsukuba Advanced Research Alliance (TARA) Research Initiative on Quality of Life of Older Japanese Adults

2000 ◽  
Vol 8 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Kiyoji Tanaka ◽  
Morihiko Okada
Keyword(s):  
Quality Of Life ◽  
Research Program ◽  
University Research ◽  
Japanese University ◽  
Research Initiative ◽  
Japanese Adults ◽  
Ibaraki Prefecture ◽  
Research Alliance ◽  
The University

An overview of the mission, research goals, structure, and organization of a major Japanese university research program is presented. The research program is part of a larger initiative known as the Tsukuba Advanced Research Alliance (TARA), which is based at the University of Tsukuba in Ibaraki Prefecture, about 60 km northeast of Tokyo. The TARA Research Foundation was established at the University of Tsukuba in May 1994.

A geriatric assessment (GA) intervention to reduce treatment toxicity in older patients with advanced cancer: A University of Rochester Cancer Center NCI community oncology research program cluster randomized clinical trial (CRCT).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12009-12009 ◽  
Author(s):  
Supriya Gupta Mohile ◽  
Mostafa Refaat Mohamed ◽  
Eva Culakova ◽  
Huiwen Xu ◽  
Kah Poh Loh ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cancer Treatment ◽  
Usual Care ◽  
Advanced Cancer ◽  
Older Patients ◽  
Treatment Intensity ◽  
Treatment Toxicity ◽  
Oncology Research ◽  
Community Oncology ◽  
Grade 3

12009 Background: GA evaluates aging-related domains (e.g., function) known to be associated with cancer treatment toxicity. In this CRCT, we evaluated if providing a GA summary with management recommendations to oncologists can reduce toxicity in older patients (pts) with advanced cancer receiving chemotherapy and/or other agents with a high reported prevalence of grade 3-5 toxicity. Methods: Pts aged > 70 with incurable solid tumors or lymphoma and > 1 impaired GA domain starting a new treatment regimen were enrolled. Community oncology practices were randomized to intervention (oncologists received GA summary/recommendations for impairments) or usual care (none given). The primary outcome was proportion of pts who experienced any grade 3-5 toxicity (CTCAE v.4) within 3 months. Practice staff prospectively captured toxicities; blinded oncology clinicians reviewed medical records to verify. Secondary outcomes included 6 month overall survival (OS) and treatment intensity (standard vs reduced). Outcomes were analyzed using generalized linear mixed/Cox models with Arm as a fixed effect, controlling for practice. Results: From 2013-19, 718 pts were enrolled from 41 practices. Age (mean 77 yrs), sex (43% women), number of impaired GA domains (median 4/8), and treatment type (chemotherapy 88%) were not different by Arm. More pts in intervention were Black (12% vs 3%, p<0.01), had GI cancer (38% vs 31%, p<0.01), and had prior chemotherapy (31% vs 23%, p=0.02). Pts in intervention experienced a lower proportion of grade 3-5 toxicity (175/349; 50%) than pts in usual care (262/369; 71%). The relative risk (RR: intervention vs usual care) of grade 3-5 toxicity was 0.74 (95% CI: 0.63-0.87; p=0.0002); the difference was mostly driven by non-heme toxicities (RR 0.73; 95% CI: 0.53-1.0, p<0.05). OS was not significantly different (71% vs 74%, p=0.3). More pts in intervention received reduced intensity treatment at cycle 1 (49% vs 35%, RR 0.81, p=0.01). Dose modifications due to toxicity were lower in intervention (42% vs 58%, p<0.0001), but results were not significant after controlling for practice (RR 0.85; 95% CI: 0.67-1.08, p=0.2). Conclusions: Providing GA information to oncologists reduces the proportion of older pts who experience grade 3-5 toxicity from high-risk palliative cancer treatment, without compromising OS. Reduced treatment intensity at cycle 1 may explain these results. Funding: R01CA177592, U01CA233167, UG1CA189961. Clinical trial information: NCT02054741 .

Development of the University of Toronto Skull Base Inventory (UT-SBI) Quality-of-Life Questionnaire

Skull Base ◽  
2009 ◽  
Vol 19 (03) ◽  
Author(s):  
John de Almeida ◽  
Allan Vescan ◽  
Jolie Ringash ◽  
Patrick Gullane ◽  
Fred Gentili ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skull Base ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
University Of Toronto ◽  
The University

A Futures Study on the Quality Of Life from the Point Of View of Iranian Youth

2017 ◽  
Vol 14 (2) ◽  
pp. 1
Author(s):  
Sina Saeedy ◽  
Mojtaba Amiri ◽  
Mohammad Mahdi Zolfagharzadeh ◽  
Mohammad Rahim Eyvazi
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
Mixed Model ◽  
Satisfaction With Life ◽  
Point Of View ◽  
Human Society ◽  
Futures Studies ◽  
The Social ◽  
The University

Quality of life and satisfaction with life as tightly interconnected concepts have become of much importance in the urbanism era. No doubt, it is one of the most important goals of every human society to enhance a citizen’s quality of life and to increase their satisfaction with life. However, there are many signs which demonstrate the low level of life satisfaction of Iranian citizens especially among the youth. Thus, considering the temporal concept of life satisfaction, this research aims to make a futures study in this field. Therefore, using a mixed model and employing research methods from futures studies, life satisfaction among the students of the University of Tehran were measured and their views on this subject investigated. Both quantitative and qualitative data were analysed together in order to test the hypotheses and to address the research questions on the youth discontentment with quality of life. Findings showed that the level of life satisfaction among students is relatively low and their image of the future is not positive and not optimistic. These views were elicited and discussed in the social, economic, political, environmental and technological perspectives. Keywords:  futures studies, quality of life, satisfaction with life, youth

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