Introduction of the quality of life concept in practical medicine

The modern stage of medical development requires a multidisciplinary approach to studying the impact of treatment on human life. The social aspects are of great importance because the goal of treatment is to preserve or/and improve life. Therefore, the term "quality of life" is increasingly used in the world medical literature. The objectification of this indicator and its adaptation in practical medicine is a priority task. The concept of "quality of life" first appeared in 1958. In the future, this concept was developed in a research carried out by a group of professors at MIT (Massachusetts Institute of Technology) under Prof. R. Bauer in 1966. These researches initiated the quality of life study. In 1996, the WHO developed a definition of quality of life as an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. The purpose of studying the quality of life in the medical field was to introduce treatment protocols and standardize medical care. An important criterion for evaluating the quality of treatment was to compare changes in the patient’s quality of life before and after using a particular medical protocol. The main methods of studying changes in the patient’s quality of life were the use of special questionnaires. The most common general-purpose questionnaires for assessing changes in quality of life are SF-36, WHOQoL-100, Sickness Impact Profile, Nottingham Health Profile, EuroQoL-5D, EORTC QLQ-C30. In Ukraine, as of 2020, there is no local questionnaire for either general or specialized purposes. But there are translations of the main questionnaires, for example, SF-36, EORTC QLQ-C30. Developing own questionnaire that fully complies with the standards of the MAPI Research Institute requires multi-center and multidisciplinary research. The study of changes in the quality of life is an integral part of a comprehensive analysis of new methods of the diagnosis, treatment and prevention of diseases. Analysis of changes in the quality of life using different approaches to treatment is possible provided that general and special purpose questionnaires and available clinical data are used. Using advanced statistical processing of the questionnaire survey allows you to increase the reliability of the research. There is a need to develop own specialized adapted nosological questionnaires for quality of life analysis. Assessment of the quality of life should become one of the main criteria for the effectiveness of medical care, as well as an independent indicator of the condition of patients during medical and social expertise, determining the prognosis, treatment tactics, and developing rehabilitation programs.

Download Full-text

Impact of individualized management of breakthrough cancer pain on quality of life in advanced cancer patients: CAVIDIOPAL study

Supportive Care in Cancer ◽

10.1007/s00520-021-06006-1 ◽

2021 ◽

Author(s):

Albert Tuca Rodríguez ◽

Miguel Núñez Viejo ◽

Pablo Maradey ◽

Jaume Canal-Sotelo ◽

Plácido Guardia Mancilla ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Pain ◽

Advanced Cancer ◽

Low Doses ◽

Breakthrough Cancer Pain ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Individualized Management ◽

The Impact

Abstract Purpose The main aim of the study was to assess the impact of individualized management of breakthrough cancer pain (BTcP) on quality of life (QoL) of patients with advanced cancer in clinical practice. Methods A prospective, observational, multicenter study was conducted in patients with advanced cancer that were assisted by palliative care units. QoL was assessed with the EORTC QLQ-C30 questionnaire at baseline (V0) and after 28 days (V28) of individualized BTcP therapy. Data on background pain, BTcP, comorbidities, and frailty were also recorded. Results Ninety-three patients completed the study. Intensity, duration, and number of BTcP episodes were reduced (p < 0.001) at V28 with individualized therapy. Transmucosal fentanyl was used in 93.8% of patients, mainly by sublingual route. Fentanyl titration was initiated at low doses (78.3% of patients received doses of 67 μg, 100 μg, or 133 μg) according to physician evaluation. At V28, mean perception of global health status had increased from 31.1 to 53.1 (p < 0.001). All scales of EORTC QLQ-C30 significantly improved (p < 0.001) except physical functioning, diarrhea, and financial difficulties. Pain scale improved from 73.6 ± 22.6 to 35.7 ± 22.3 (p < 0.001). Moreover, 85.9% of patients reported pain improvement. Probability of no ≥ 25% improvement in QoL was significantly higher in patients ≥ 65 years old (OR 1.39; 95% CI 1.001–1.079) and patients hospitalized at baseline (OR 4.126; 95% CI 1.227–13.873). Conclusion Individualized BTcP therapy improved QoL of patients with advanced cancer. Transmucosal fentanyl at low doses was the most used drug. Trial registration This study was registered at ClinicalTrials.gov database (NCT02840500) on July 19, 2016.

Download Full-text

Quality of Life Among Disease-Free Survivors of Rectal Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2004.03.137 ◽

2004 ◽

Vol 22 (2) ◽

pp. 354-360 ◽

Cited By ~ 153

Author(s):

Philippe Rauch ◽

Joelle Miny ◽

Thierry Conroy ◽

Lionel Neyton ◽

Francis Guillemin

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Cancer Survivors ◽

German Population ◽

European Organization ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Impact ◽

Disease Free

Purpose To identify factors affecting the quality of life (QoL) of disease-free survivors of rectal cancer. Patients and Methods One hundred twenty-one patients in complete remission more than 2 years after diagnosis were asked to complete three QoL questionnaires: the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30; its colorectal module, QLQ-CR38; and the Duke generic instrument. Results Patients reported less pain (P = .002) than did controls drawn from the general population. EORTC QLQ-C30 physical scores were also higher among rectal cancer survivors than in the general Norwegian or German population (P = .0005 and P = .002, respectively). Unexpectedly, stoma patients reported better social functioning than did nonstoma patients (P = .005), with less anxiety (P = .008) and higher self-esteem (P = .0002). In the present authors' experience, the QLQ-CR38 does not discriminate between these groups. Residual abdominal or pelvic pain and constipation had the most negative influence on QoL. Conclusion QoL is high among rectal cancer survivors, including stoma patients. Simultaneous use of several QoL questionnaires appears to have value in follow-up and in monitoring the effects of therapy. The impact of residual pain and constipation on long-term QoL should be considered when establishing a treatment regimen.

Download Full-text

Impact of intermittent (I) first-line docetaxel (D)-based chemotherapy on quality of life (QL) of patients (pts) with castration-resistant prostate cancer (CRPC): Results of a phase II randomized trial.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.6_suppl.90 ◽

2013 ◽

Vol 31 (6_suppl) ◽

pp. 90-90

Author(s):

Orazio Caffo ◽

Teodoro Sava ◽

Umberto Basso ◽

Sebastiano Buti ◽

Giovanni Lo Re ◽

...

Keyword(s):

Quality Of Life ◽

Rest Period ◽

Castration Resistant Prostate Cancer ◽

First Line ◽

Castration Resistant ◽

Eortc Qlq C30 ◽

Assessment Time ◽

Eortc Qlq ◽

The Impact

90 Background: Eight consecutive courses of D are usually considered a standard first line treatment for CRPC pts. The pts quality of life (QL) may be worsened and an I administration could mitigate this effect. We verified if an I therapy may reduce the impact on pts’ QL compared to continuous (C) treatment. Methods: The treatment was D 70 mg/m2IV q 3 wks ± estramustine (E) 280 mg/TID PO for 5 days. Pts were randomized to receive 8 courses D±E continuously (C) or intermittently, with a 3-month rest period after the first 4 courses. QL was evaluated by EORTC QLQ C30 at baseline and every 6 weeks. For the study aim, we considered evaluable for QL pts who received at least 5 D±E courses and filled the QL instruments. Results: 148 CRPC pts were enrolled from 11/06 to 10/10 with 94 pts evaluable for QL (53 and 41 treated with I with C therapy, respectively). No statistically differences were observed between C and I treatments for QL outcomes: the table shows the median value of single EORTC QLQ C30 scales scores at each assessment time-point. Conclusions: The present study failed to demonstrate that I treatment may produce a QL advantage compared to C treatment which remains the reference therapy for first-line of CRPC pts. Clinical trial information: 2006-005728-17. [Table: see text]

Download Full-text

Health-related quality of life assessed by the EORTC QLQ-C30 questionnaire in the general slovenian population

Radiology and Oncology ◽

10.1515/raon-2017-0021 ◽

2017 ◽

Vol 51 (3) ◽

pp. 342-350 ◽

Cited By ~ 11

Author(s):

Vaneja Velenik ◽

Ajra Secerov-Ermenc ◽

Jasna But-Hadzic ◽

Vesna Zadnik

Keyword(s):

Quality Of Life ◽

Health Related Quality ◽

Linear Regression Models ◽

Slovenian Population ◽

Related Quality ◽

Eortc Qlq C30 ◽

Health Related ◽

Eortc Qlq ◽

The Impact

Abstract Background The aim of our study was to obtain reference data of the EORTC QLQ-C30 quality of life dimensions for the general Slovenian population. We intend to provide the researchers and clinicians in our country with the expected mean health-related quality of life (HRQL) scores for distinctive socio-demographic population groups. Methods The EORTC QLQ-C30 questionnaire supplemented by a socio-demographic inquiry was mailed or distributed to 1,685 randomly selected individuals in the Slovenian population aged 18 – 90. Answers from 1,231 subjects representing socio-demographic diversity of the Slovenian population were collected and transformed into EORTC dimensions and symptoms. The impact of socio-demographic features on HRQL scores was assessed by multiple linear regression models. Results Gender, age and self-rated social class are the important confounders in the quality of life scores in our population. Men reported better quality of life on the majority of the specific scales and, at the same time, reported fewer symptoms. There was no gender-specific difference in cognitive functioning. The mean scores were consistently lower with age in both sexes. Conclusions This is the first study to report the normative EORTC QLQ-C30 scores for one of the south-eastern European populations. The reported expected mean scores allow Slovenian oncologists to estimate what the quality of life in cancer patients would be, had they not been ill. As they are derived by common methodology, our results can easily be included in any further international comparisons or in the calculation of European summarized HRQL scores.

Download Full-text

QUALITY OF LIFE OF PATIENTS WITH OVARIAN CANCER OF THE THIRD STAGE USING DIFFERENTIATED TREATMENT

EUREKA Health Sciences ◽

10.21303/2504-5679.2017.00405 ◽

2017 ◽

Vol 5 ◽

pp. 37-43

Author(s):

Andriy Rybin

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Life Quality ◽

Results Of Treatment ◽

Sf 36 ◽

Third Stage ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Relationship

The aim of this research was to assess the quality of life in patients with stage III ovarian cancer during the treatment period, depending on the applied therapeutic approaches. A comparative analysis of the results of treatment of 350 patients with adenocarcinoma of the ovaries of III-IV stage, which have undergone suboptimal or non-optimal cytomelective surgery, was conducted. To assess the quality of life and to examine the relationship between changes in physical health and quality of life, patients in both groups were asked to complete the questionnaires EORTC QLQ-C30 and SF-36. According to the questionnaire of the EORTC QLQ-C30, the indicators of physical activity, the ability to do everyday affairs, were higher in the second group of patients who received differentiated treatment. The indicator of "social functioning" was also higher in the II group of patients. When evaluating the patients' liver on the scale of the questionnaire SF-36, it was found that the positive effect of differentiated therapy is maintained for 3 years. Life quality is an important criterion for evaluating the results of antitumor therapy, and when it is continuously monitored in patients with ovarian cancer the safety of treatment for patients could be improved, including at an advanced stage

Download Full-text

Health-related quality of life in Croatian general population and multiple myeloma patients assessed by the EORTC QLQ-C30 and EORTC QLQ-MY20 questionnaires

Radiology and Oncology ◽

10.2478/raon-2019-0047 ◽

2019 ◽

Vol 53 (3) ◽

pp. 337-347 ◽

Cited By ~ 1

Author(s):

Sanja Ledinski Ficko ◽

Vlatko Pejsa ◽

Vesna Zadnik

Keyword(s):

Quality Of Life ◽

Multiple Myeloma ◽

General Population ◽

Health Related Quality ◽

Related Quality ◽

Eortc Qlq C30 ◽

Health Related ◽

Eortc Qlq ◽

The Impact

Abstract Background The impact of disease and treatment on the patient’s overall well-being and functioning is a topic of growing interest in clinical research and practice. The aim of this study is to obtain reference data on quality of life of Croatian general population. Further, we aim to assess the impact of the disease and its primary systemic treatment on their health related quality of life (HrQoL) in multiple myeloma (MM) patients. Patients and methods Participants for the first part of the study were randomly selected from adult Croatian population. In the clinical part of the study MM patients were included as prospectively diagnosed within two years in two major Croatian haematological centres. The EORTC QLQ-C30 in both trials and QLQ-MY20 in MM patients only were applied for HrQoL assessment. Results Gender, age and place of residence have great impact on quality of life scores in Croatian population. The MM patients at the time of diagnosis have lower QLQ-C30 scores for global quality of life, functional and symptom scale scores, as well as single items. The type of disease followed by the choice of therapy options are important HrQoL determinants. Conclusions The norm values available now for Croatian population will help to interpret HrQoL for clinicians and aid in planning cancer care interventions. This study identified treatment effect consistent with those from other observational studies and provided new data on HrQoL across two different treatment choices for MM patients.

Download Full-text

Evaluation of Quality of Life in Patients with Malignant Dysphagia

Tumori Journal ◽

10.1177/030089160008600205 ◽

2000 ◽

Vol 86 (2) ◽

pp. 134-138 ◽

Cited By ~ 8

Author(s):

Cinzia Brunelli ◽

Paola Mosconi ◽

Paolo Boeri ◽

Laura Gangeri ◽

Paolo Pizzetti ◽

...

Keyword(s):

Quality Of Life ◽

Esophageal Cancer ◽

Malignant Disease ◽

Malignant Dysphagia ◽

Eortc Qlq C30 ◽

C 30 ◽

Eortc Qlq ◽

The Impact ◽

Adequate Management

Background In the last 10 years of clinical research there has been increasing interest in the evaluation of quality of life. Several generic and specific instruments have been developed for this purpose. EORTC QLQ C-30 is a cancer-specific questionnaire translated into various languages and validated in several European countries including Italy, where the impact of malignant disease on different areas of quality of life is poorly documented. Methods The EORTC QLQ C-30 was administered to 109 patients referred to the endoscopy division of the Istituto Nazionale Tumori, Milan, for endoscopic palliative treatment of malignant dysphagia to test its characteristics in terms of acceptability and clinical validity. Results In this group of patients the impact of advanced esophageal cancer was highly evident for Emotional and Physical Functioning, Fatigue and Global QoL scales. Dysphagia is a serious problem for many patients; there is a correlation between grade of dysphagia and four QoL dimensions. Conclusions QoL assessment is an important tool to evaluate the adequate management of patients with esophageal cancer. The EORTC QLQ-C30 questionnaire proved to be valid and reliable also in this population.

Download Full-text

Impact of functional outcomes on long-term quality of life after open retropubic radical prostectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.9580 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 9580-9580

Author(s):

Bjoern Loeppenberg ◽

Christian von Bodman ◽

Marko Brock ◽

Joachim Noldus ◽

Jueri Palisaar

Keyword(s):

Quality Of Life ◽

Erectile Dysfunction ◽

Erectile Function ◽

Functional Outcomes ◽

Term Survival ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

The Impact

9580 Background: Patients who underwent open retropubic radical prostatectomy (ORRP) for prostate-cancer (PCA) have excellent long-term survival. Besides oncologic safety, recovery of continence and erectile function are highly important, as adverse functional outcomes may have a detrimental effect on health-related quality of life (HRQOL). We report the long-term HRQOL of PCA survivors after ORRP using standardized tools. Methods: Men treated between August 2003 and December 2007 with ORRP for localized PCA at a single academic hospital received validated questionnaires (International consultation on incontinence questionnaire (ICIQ), International index of erectile function (IIEF-5), Erection hardness score (EHS), EORTC QLQ-C30) to assess functional outcomes and HRQOL. Results were correlated with the global-health score (GHS) of the EORTC QLQ-C30 to assess the impact of ORRP on HRQOL. Results: In the study period 1936 men underwent ORRP of whom 1156 (59.7%) received a nerve-sparing (NS) procedure. Questionnaire return-rate was 59% (n=1141) comprising the final study cohort. Median follow-up (FU) was 62 months. Mean age at surgery and FU was 63.7±6.2 and 69.2±6.2 years, respectively. Biochemical recurrence (BCR) occurred in 17.5% (n=200/1141) and 2% (n=40/1936) deceased. Mean GHS in the study population was 71.5±20.8. In the ICIQ 28% (n=320) scored 0 indicating complete continence and 9.9% (n=113) scored ≥11 indicating severe incontinence. The corresponding GHS was 78.1±19.5 and 55.4±21.8, respectively. 68.5% (n=782) of patients used no pads and 17.9% (n=204) ≥2 pads. Corresponding GHS scores were 74.9±19.8 and 58.9±20.7. Using the IIEF-5 in men who received NS, 24.1% (n=154) had no erectile dysfunction versus 50% (n=318) using the EHS. Corresponding GHS scores were 82.2±16.3 and 74.7±19.8, respectively. Patients with BCR had a GHS of 66.8±21.8 versus 72.5±20.5 for patients without. Men who achieved the Trifecta and Pentafecta criteria had a GHS of 83.1±15.1 and 83.3±15, respectively. Conclusions: Incontinence severely impacts the HRQOL of long-term survivors after ORRP while erectile dysfunction and BCR have a lesser effect. Every effort should be undertaken to maintain functional integrity.

Download Full-text

QOLP-32. EFFECT OF CANNABIS USE ON QUALITY OF LIFE AMONG GLIOMA PATIENTS: A LONGITUDINAL PERSPECTIVE

Neuro-Oncology ◽

10.1093/neuonc/noab196.752 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi190-vi190

Author(s):

Eduardo Rodriguez Almaraz ◽

Susan Chang ◽

Nancy Ann Oberheim-Bush ◽

Jennifer Clarke ◽

Jennie Taylor ◽

...

Keyword(s):

Quality Of Life ◽

Cannabis Use ◽

Primary Tumors ◽

Eortc Qlq C30 ◽

Term Basis ◽

The Central Nervous System ◽

The Difference ◽

Eortc Qlq ◽

The Impact

Abstract BACKGROUND Gliomas are devastating primary tumors of the central nervous system that often present with difficult to manage symptoms in addition to the antineoplastic tumor itself. Due to recent increase in popularity and societal acceptance of cannabis products, their use by glioma patients has increased. METHODS We conducted a single center, prospective study: patients with glioma answered a locally validated survey to inquire about their cannabis use at baseline and every three months. Quality of Life was measured using the EORTC QLQ-C30, its complementary module BN-20 and the EQ-5D-5L instrument. Eligible participants were classified as cannabis users or non-users. We performed linear regression clustered by subjects to see differences by user group and trends overtime. RESULTS To date, 89 patients agreed to participate, enrolled, and answered the baseline questionnaires, and 64 have answered the 3 month follow up survey. The mean age was 49.7(SD 13.74), 55 were male, 55 were cannabis users at baseline (61.8%) and 34 at 3 months (53.13%). Patients who were cannabis users scored 11.73 lower points at baseline when compared to non-users (79.65 [SD 18.93] vs 67.92 [SD 19.22]) in the QLQ-C30 instrument. Similarly, cannabis users recorded 9.624 lower points at 3 months compared to non-users (70.1 [SD 21.33] vs 79.72 [SD13.95]). The difference-in-difference estimator was 2.108 (p< 0.7). CONCLUSION Although we observed cannabis users scoring lower QoL measurements (p< 0.05) at baseline and 3 months, we observed a slight improvement in QoL of cannabis users while observing no change or decline (in some measures) among non-users. Our findings provide insight to the impact that cannabis has in QoL over time. While not conclusive, these preliminary results need to be studied on a longer-term basis with a larger sample size in order to detect trends on quality of life among patients with different tumor types.

Download Full-text