scholarly journals Pharmaceutical Intervention for Adverse Events Improves Quality of Life in Patients With Cancer Undergoing Outpatient Chemotherapy

2021 ◽  
Author(s):  
Hironori Fujii ◽  
Yukino Ueda ◽  
Chiemi Hirose ◽  
Koichi Ohata ◽  
Kumiko Sekiya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Cancer Chemotherapy ◽  
Japanese Version ◽  
Nausea And Vomiting ◽  
University Hospital ◽  
Post Intervention ◽  
Pharmaceutical Intervention ◽  
Utility Values

Abstract PurposeThe effect of pharmaceutical intervention to treat adverse events on quality of life (QOL) in outpatients receiving cancer chemotherapy is unclear. We investigated whether pharmaceutical intervention provided by pharmacists in collaboration with physicians improves QOL with outpatient cancer chemotherapy. MethodsWe conducted a single-center retrospective descriptive study of pharmaceutical intervention for patients receiving outpatient cancer chemotherapy at Gifu University Hospital between September 2017 and July 2020. We assessed patient QOL using the Japanese version of the EuroQol 5 Dimension5 Level (EQ-5D-5L). Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. We compared the EQ-5D-5L utility value and incidence of grade 2 or higher adverse events before and after pharmaceutical intervention. ResultsOur analysis included 151 patients who underwent 210 chemotherapy cycles. Pharmaceutical intervention significantly improved patients’ EQ-5D-5L utility values from 0.8197 to 0.8603 (P < 0.01). EQ-5D-5L utility values were significantly improved after pharmaceutical intervention for nausea and vomiting (pre-intervention 0.8145, post-intervention 0.8603, P = 0.016), peripheral neuropathy (pre-intervention 0.7798, post-intervention 0.7988, P = 0.032) and pain (pre-intervention 0.7625, post-intervention 0.8197, P = 0.035). Although not statistically significant, the incidence of grade 2 or higher adverse events, including nausea and vomiting, dermopathy, pain, oral mucositis, diarrhea and dysgeusia, tended to be lower post-intervention than pre-intervention. ConclusionsPharmaceutical intervention by pharmacists in collaboration with physicians may improve QOL in patients undergoing outpatient cancer chemotherapy.

scholarly journals UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Devaki Nimalan ◽  
Michal Kawka ◽  
Simon Erridge ◽  
Mehmet Ergisi ◽  
Michael Harris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Adverse Events ◽  
Symptom Control ◽  
Case Series ◽  
Nausea And Vomiting ◽  
Medical Cannabis ◽  
Patient Reported ◽  
The Uk

Abstract Introduction Palliative care aims to improve quality of life through optimal symptom control and pain management. Cannabis-based medicinal products (CBMPs) have a proven role in the treatment of chemotherapy-induced nausea and vomiting. However, there is a paucity of high-quality evidence with regards to the optimal therapeutic regimen, safety, and effectiveness of CBMPs in palliative care, as existing clinical trials are limited by methodological heterogeneity. The aim of this study is to summarise the outcomes of the initial subgroup of patients from the UK Medical Cannabis Registry who were prescribed CBMPs for a primary indication of palliative care, cancer pain and chemotherapy-induced nausea and vomiting, including effects on health-related quality of life and clinical safety. Methods A case series from the UK Medical Cannabis Registry of patients, who were receiving CBMPs for the indication of palliative care was undertaken. The primary outcome consisted of changes in patient-reported outcome measures including EQ-5D-5L, General Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), Pain Visual Analog Scale (VAS) and the Australia-Modified Karnofsky Performance Scale at 1 and 3 months compared to baseline. Secondary outcomes included the incidence and characteristics of adverse events. Statistical significance was defined by p-value< 0.050. Results Sixteen patients were included in the analysis, with a mean age of 63.25 years. Patients were predominantly prescribed CBMPs for cancer-related palliative care (n = 15, 94%). The median initial CBD and THC daily doses were 32.0 mg (Range: 20.0–384.0 mg) and 1.3 mg (Range: 1.0–16.0 mg) respectively. Improvements in patient reported health outcomes were observed according to SQS, EQ-5D-5L mobility, pain and discomfort, and anxiety and depression subdomains, EQ-5D-5L index, EQ-VAS and Pain VAS validated scales at both 1-month and 3-months, however, the changes were not statistically significant. Three adverse events (18.75%) were reported, all of which were either mild or moderate in severity. Conclusion This small study provides an exploratory analysis of the role of CBMPs in palliative care in the first cohort of patients since CBMPs legalisation in the UK. CBMPs were tolerated with few adverse events, all of which were mild or moderate and resolved spontaneously. Further long-term safety and efficacy studies involving larger cohorts are needed to establish CBMPs role in palliative care, including comparisons with standard treatments.

scholarly journals Effect of Educational Intervention Guideline on Quality of Life among Women with Polycystic Ovary Syndrome

2020 ◽  
Vol 1 (4) ◽  
pp. 14
Author(s):  
Aziza I. Mohamed ◽  
Shimaa A. Moustafa
Keyword(s):  
Quality Of Life ◽  
Polycystic Ovary Syndrome ◽  
Educational Intervention ◽  
Polycystic Ovary ◽  
University Hospital ◽  
Life Questionnaire ◽  
Post Intervention ◽  
Ovary Syndrome ◽  
Significant Difference

Contexts: Polycystic ovary syndrome is a common endocrine disorder among women at the childbearing period that diminished women’s quality of life. Aim: The current study evaluated the effect of educational intervention guidelines on quality of life among women with polycystic ovary syndrome. Methods: The current study conducted at the outpatient gynecological clinic at Benha University Hospital. A Quasi-experimental design used to collect data from a purposive sample of 98 women diagnosed with polycystic ovary syndrome. Three tools used for data collection.  A structured interviewing questionnaire, a healthy practice assessment scale, and health-related quality of life questionnaire for polycystic ovary syndrome. Results: The study findings revealed that women's knowledge mean score was increased from (8.84±5.72) pre-intervention to (33.56±3.91) at post-intervention. Besides, the healthy practice was satisfactory improved, as practice mean score was increased from (11.41±4.56) to (28.85±2.47) at the post-intervention phase, with a statistically significant difference between the two phases, that subsequently affect the improvement of studied women’s quality of life. Conclusion: An educational intervention guideline is effectively improving the quality of life of women with polycystic ovary syndrome. Educational intervention guideline is essentially recommended for women with polycystic ovary in order to improve different quality of life domains. Counseling and health education program must be provided to all women attended gynecological clinics to increases women knowledge regarding PCOS and its management, to enable early detection, and to improve their quality of life. A replication of the study on a larger probability sample in order to obtain generalizability is highly recommended.

scholarly journals Quality of Life During Chemotherapy for Breast Cancer in a West African Population in Dakar, Senegal: A Prospective Study

2019 ◽  
pp. 1-9
Author(s):  
Domitille Dano ◽  
Clémence Hénon ◽  
Ousseynou Sarr ◽  
Kanta Ka ◽  
Mouhamadou Ba ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Prospective Study ◽  
Locally Advanced ◽  
Lymph Node Involvement ◽  
Nausea And Vomiting ◽  
University Hospital ◽  
Cancer Therapies ◽  
Middle Income

PURPOSE The prevalence of breast cancer is increasing in low- to middle-income countries such as Senegal. Our prospective study assessed the quality of life (QoL) of patients with breast cancer undergoing chemotherapy in Senegal. PATIENTS AND METHODS Our study included women with breast cancer undergoing chemotherapy as initial treatment at the Center Aristide Le Dantec University Hospital in Dakar. Clinical, sociodemographic, and QoL data were collected and analyzed at three different times: baseline, 3 months, and 6 months after the start of systemic therapy. Health-related QoL was assessed using a Functional Assessment of Cancer Therapies-Breast (FACT-B) questionnaire after translation into the Wolof language. Linear mixed-effects models were performed to assess the changes in QoL scores. RESULTS Between July 2017 and February 2018, 120 patients were included in the study. Their median age was 45 years. Most patients (n = 105; 92%) had locally advanced disease (T3 to T4 stage) and lymph node involvement (n = 103; 88%), and half had metastatic disease. The FACT-B total scores significantly improved over time (β = 1.58; 95% CI, 0.50 to 2.67; P < .01). Nausea and vomiting were significantly associated with a decrease in FACT-B total scores (β = −16.89, 95% CI, −29.58 to −4.24, P = .012; and β = −13.44, 95% CI, −25.15 to −1.72, P = .028, respectively). CONCLUSION Our study confirmed the feasibility of standardized QoL assessment in Senegalese patients with breast cancer. Our results indicated a potential improvement of QoL over the course of chemotherapy. Optimizing nausea and vomiting prevention may improve QoL.

scholarly journals Effectiveness of ultrasound-guided percutaneus neuromodulation on peripheal neuropathies induced by chemotherapy: a pilot study

2019 ◽  
Vol 02 (02) ◽  
pp. 084-085
Author(s):  
López-Garzón MC ◽  
Lozano-Lozano M. ◽  
Álvarez-Salvago F. ◽  
Galiano-Castillo N.
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Colorectal Cancer ◽  
Pilot Study ◽  
Treatment Protocol ◽  
University Hospital ◽  
Quality Of Sleep ◽  
Post Intervention ◽  
Eortc Qlq

Abstract Background and Aims Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most invalidating secondary effects (60%) both of colorectal cancer as well as breast cancer and is a reason for abandoning medical treatment. The symptoms are based on pain, tingling, numbness, and can affect quality of sleep. It is known that analgesia induced by TENS is multifactorial and probably comprises peripheral, spinal and supraspinal mechanisms. Besides, these effects could be greater if the application is performed percutaneously. Therefore, the principal aim of this study was to evaluate the effectiveness of ultrasound-guide percutaneous neuromodulation on the quality of life of patients who suffer CIPN. Material and Methods Three patients (n = 2 breast cancer and n = 1 colorectal cancer) were recruited from the University Hospital Virgen de las Nieves (Granada, Spain). This study received ethics committee approval (0110-N-18) The radial, cubital and median nerves were treated in the upper limb, and the tibial, peroneal, sural and saphenous nerves were treated for the lower limb. In total, eight treatment sessions were performed per affected limb, using the treatment protocol of NMP® (20 seconds of TENS 10Hz 2mA and 10 minutes of TENS 2Hz 1-10mA and in the sural nerve. Besides, 5 minutes of TENS was applied TENS 50Hz 1-10mA) in a weekly session during two months. Before and after treatment, the following variables were evaluated: 1) neuropathy specific quality of life (EORTC QLQ-CIPN20) consisting of three subscales (0-100): sensory, autonomic, motor (greater conduction); 2) intensity of symptoms (numbness, pain and tingling) using the visual analog scale (VAS) (0-10); and 3) sleep according to the Pittsburgh Sleep Quality Index (0-21) using its total component. For the analyses, the normality of the population was assumed due to the nature of the study (N = 3) and therefore the Student's t-test was used to analyze the differences in the baseline and post-intervention means using the IBM SPSS Statistics 21 software (IBM Corporation, Armonk, NY). Results Regarding the autonomic subscale (baseline mean, SD 38.89 ± 5.56) of the EORTC QLQ-CIPN20 the difference of means was statistically significant (-38.89 ± 9.62) (t = -6.99; P = 0.020). The remaining subscales were not significant (P > 0.05) despite the fact that the results also improved: sensory (-2.47 + -16.7); motor (-26.89 ± 19.25); and conduction (-11.11 ± 19.25). The VAS for pain (baseline mean, SD: 5 ± 2.52) obtained a difference in means of −1.67 ± 2.08, although it was not significant (P > 0.05) it did reach a clinically relevant difference (1.1 points). For the remaining VAS scales, numbing and tingling, no statistically significant differences were obtained −1.17 ± 2.021 and −1.5 ± 1.80, respectively (P > 0.05). Lastly, the Pittsburgh questionnaire (baseline mean: 10) decreased by −3.67 ± 1.53 showing a trend towards significance (t = -4.19; P= 0,053). Conclusion Despite this being a pilot study, percutaneous neuromodulation is shown to improve the symptoms of neuropathy induced by chemotherapy, specifically autonomic symptoms and quality of sleep. Our results may represent a change of paradigm in physical therapy treatment.

scholarly journals Anorexia, pain and peripheral neuropathy are associated with a decrease in quality of life in patients with advanced pancreatic cancer receiving outpatient chemotherapy — a retrospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hironori Fujii ◽  
Maaya Koda ◽  
Shiori Sadaka ◽  
Koichi Ohata ◽  
Hiroko Kato-Hayashi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Logistic Regression ◽  
Peripheral Neuropathy ◽  
Adverse Events ◽  
Advanced Pancreatic Cancer ◽  
Utility Value ◽  
Pharmaceutical Intervention ◽  
Outpatient Chemotherapy

Abstract Background Cancer chemotherapy usually improves clinical outcomes in patients with advanced pancreatic cancer (APC), but can also cause moderate-to-severe adverse events (AEs). We investigated the relationship between moderate-to-severe AEs and quality of life (QOL) in patients with APC who received outpatient chemotherapy. Methods We recruited APC patients who received outpatient chemotherapy in Gifu University Hospital between September 2017 and December 2018. Adverse events related to chemotherapy were assessed by a pharmacist collaborating with a physician using common terminology criteria for AEs (CTCAE) ver 4.0, and QOL of patients was self-assessed by patients using the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L Japanese edition 2). Associations between the EQ-5D-5L utility value and serious AEs were assessed using proportional odds logistic regression. Results A total of 59 patients who received 475 chemotherapy cycles were included. The proportional odds logistic regression indicated that grade ≥ 2 anorexia, pain and peripheral neuropathy were significantly correlated with a decreased EQ-5D-5L utility value. Pharmaceutical intervention for these AEs significantly improved the patients’ EQ-5D-5L utility value. Conclusions Anorexia, pain and peripheral neuropathy were significantly associated with a decrease in QOL. It is assumed that appropriate pharmaceutical intervention with particular emphasis on these AEs can improve the QOL of pancreatic cancer patients receiving outpatient chemotherapy.

scholarly journals P602 Vedolizumab subcutaneous influencing disease course in Constant-care app solution

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S547-S548
Author(s):  
J Nørgaard ◽  
R Malte ◽  
P L Charlotte ◽  
B Mette ◽  
F Eva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Adverse Events ◽  
Controlled Trial ◽  
Severe Disease ◽  
University Hospital ◽  
Sustained Remission ◽  
Serious Adverse Events ◽  
Crohns Disease

Abstract Background The Constant-care app solution (CC) has been shown to empower patients with mild-moderate Ulcerative Colitis (UC) in 5-ASA treatment and improve disease specific quality of life (1). Here we present preliminary data on our study to investigate the effects of CC on quality of life in patients with moderate-severe UC or Crohns Disease (CD) treated with s.c.vedolizumab, launched in June 2020 in Denmark. Methods The study is an ongoing non-interventional, observational study. Patients are homemonitored via CC for 24 months. CC shows data on patient’s disease status, grouping them into three: green (remission), yellow (worsening), red (severe disease). Patients were recruited from the outpatient clinic at the Department of Gastroenterology, North Zealand University Hospital, Greater Copenhagen. Simple Clinical Colitis Index (SCCAI), Harvey-Bradshaw Index (HB-I), Fecal calprotectin (FC) and short QoL (0–70) are measured every two months or during a flare up between fixed screenings. Serious adverse events (SAE) and adverse events (AE) are monitored. Results 19 patients out of 40 have been included, 8 with CD and 11 with UC. None experienced SAEs. Five experienced AEs, of which four discontinued treatment. One patient experienced treatment failure during this study. Of the 15 patients, two are in complete remission, (Q2 respectively Q3). Five of the remaining patients have not entered more than two data entries in CC (data not shown).All patients sustained remission based on FC, except for two data points for two individual patients. Good QoL ≥ 50 was almost unchanged for 6 patients. Conclusion IBD CC has proven a usefull tool for surveillance and maintenance of remission in IBD patients treated with s.c. vedolizumab. S.c. vedolizumab has in this patientgroup, shown to provide sustainable QoL, sustained remission, and to have few AEs. 1) Elkjaer M, Shuhaibar M, Burisch J, Bailey Y, Scherfig H, Laugesen B, et al. E-health empowers patients with ulcerative colitis: a randomised controlled trial of the web-guided ‘Constant-care’ approach. Gut. 2010;59(12):1652–61.

scholarly journals Real-world data of the association between quality of life using the EuroQol 5 Dimension 5 Level utility value and adverse events for outpatient cancer chemotherapy

2020 ◽  
Vol 28 (12) ◽  
pp. 5943-5952
Author(s):  
Chiemi Hirose ◽  
Hironori Fujii ◽  
Hirotoshi Iihara ◽  
Masashi Ishihara ◽  
Minako Nawa-Nishigaki ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Peripheral Neuropathy ◽  
Adverse Events ◽  
Cancer Chemotherapy ◽  
Proportional Odds ◽  
Utility Value ◽  
Serious Adverse Events ◽  
Outpatient Chemotherapy

Abstract Background Outpatient cancer chemotherapy may lead to improved quality of life (QOL) by allowing treatment to continue without impairing the social lives of patients compared with hospitalization. However, the occurrence of serious adverse events may cause a decline in QOL. We investigated the relationship between outpatient chemotherapy–induced adverse events and QOL. Methods A single-center retrospective descriptive study was conducted in patients who received outpatient chemotherapy at Gifu University Hospital (Gifu, Japan) between September 2017 and December 2018. The utility values of QOL, type and severity of adverse events, type of cancer, chemotherapy regimen, and other patient demographics were analyzed. Adverse events were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L). Associations between the EQ-5D-5L utility value and serious adverse events were assessed using adjusted (age and sex) odds ratios obtained with a proportional odds logistic regression model. Results Data from 1008 patients who received 4695 chemotherapy cycles were analyzed. According to proportional odds logistic regression, the adverse events that significantly correlated with a decreased EQ-5D-5L utility value were malaise, edema of the limbs, peripheral neuropathy, pruritus, and dry skin. Based on the proportional odds logistic analysis, neither cancer type nor anticancer drugs were significantly correlated with the EQ-5D-5L utility value in patients who received chemotherapy. Pharmaceutical care for peripheral neuropathy significantly improved patients’ EQ-5D-5L utility value from 0.747 to 0.776 (P < 0.01). Conclusions Adverse events (i.e., peripheral neuropathy, malaise, and edema of the limbs) are significantly correlated with a decrease in QOL, regardless of the type of cancer or anticancer drugs used. Pharmaceutical care provided by pharmacists in collaboration with physicians may improve QOL.

Eating Disorders Quality of Life Scale--Japanese Version

2020 ◽  
Author(s):  
Ryo Yoneda ◽  
Makoto Otani ◽  
Maiko Hiraide ◽  
Takeshi Horie ◽  
Tomoyo Mitsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Eating Disorders ◽  
Japanese Version ◽  
Quality Of Life Scale ◽  
Life Scale
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