Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-26T12:07:47.726Z Has data issue: false hasContentIssue false

Health-related quality of life measures in routine clinical care: Can FACT-Fatigue help to assess the management of fatigue in cancer patients?

Published online by Cambridge University Press:  06 January 2009

Maria-Jose Santana
Affiliation:
University of Alberta Hospital
Heather-Jane Au
Affiliation:
University of Alberta and Cross Cancer Institute
Melina Dharma-Wardene
Affiliation:
Bethany Care Society
Joanne D. Hewitt
Affiliation:
University of Alberta and Cross Cancer Institute
David Dupere
Affiliation:
Dalhousie University and QEII Health Sciences Centre
John Hanson
Affiliation:
Cross Cancer Institute and University of Alberta
Sunita Ghosh
Affiliation:
Cross Cancer Institute and University of Alberta
David Feeny
Affiliation:
University of Alberta and Kaiser Permanente Northwest

Abstract

Objectives: Fatigue is the most common symptom reported by cancer patients. The inclusion of health-related quality of life (HRQL) measures in routine clinical care of cancer patients may improve the management of fatigue. The primary objective of this study is to provide evidence on the magnitude of change in fatigue subscale scores using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) that is clinically important.

Methods: Consecutive patients with advanced primary lung cancer attending a Canadian tertiary care cancer and, prior to undergoing palliative chemotherapy, were enrolled in the study. Patients completed a battery of questionnaires [FACT-F, Qualitative Patients Self-report of Fatigue Level (QPSRF)] at baseline, follow-up and 2 weeks after their final cycle of chemotherapy. Clinicians assessed the patients using the Eastern Cooperative Oncology Group (ECOG) Performance Status Scale at baseline and each follow-up visit. FACT-F change scores were computed as the mean change in score (end of study score minus baseline score).

Results: A total of 43 patients with mean age of 59 years were enrolled in the study. Results revealed a mean change in FACT-F subscale score of 5.0 (SE 1.06) for those who rated themselves as more tired, 1.28 (SE 1.00) for those who rated themselves as the same (no change), and −1.52 (SE 0.84) for those patients who rated themselves as less tired.

Conclusions: We provide evidence on the magnitude of change in FACT-F score that is associated with the perception by patients of improvement in fatigue and magnitude of change in score that is associated with worsening in fatigue.

Type
Research Reports
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Barnes, EA, Bruera, E. Fatigue in patients with advanced cancer: A review. Int J Gynecol Cancer. 2002;12:424428.Google Scholar
2. Bruera, E, Valero, V, Driver, L, et al. Patient-controlled methylphenidate for cancer fatigue: A double-blind, randomized, placebo-controlled trial. J Clin Oncol. 2006;24:20732078.Google Scholar
3. Cella, DF, Tulsky, DS, Gray, G, et al. The functional assessment of cancer therapy scale: Development and validation of the general measure. J Clin Oncol. 1993;1:570579.CrossRefGoogle Scholar
4. Cella, D, Hahn, E, Dineen, K. Meaningful change in cancer-specific quality of life scores: Differences between improvement and worsening. Qual Life Res. 2002;11:207221.Google Scholar
5. Cella, D, Paul, D, Yount, S, et al. What are the most important symptom targets when treating advanced cancer? a survey of providers in the National Comprehensive Cancer Network (NCCN). Cancer Invest. 2003;21:526535.Google Scholar
6. Cella, D. Quality of life and clinical decisions in chemotherapy-induced anemia. Oncology (Williston Park). 2006;20 (Suppl 6):2528.Google ScholarPubMed
7. Dharma-Wardene, M, Au, HJ, et al. Baseline FACT -G score is a predictor of survival for advanced lung cancer. Qual Life Res. 2004;13:1209–1206.Google Scholar
8. Goldberg, D. Manual of the general health questionnaire. Windsor: NFER; 1978.Google Scholar
9. Guyatt, GH, Naylor, CD, Juniper, E, et al. Users’ guides to the medical literature. XII. How to use articles about health-related quality of life. Evidence-Based Medicine Working Group. JAMA. 1997;277:12321237.CrossRefGoogle Scholar
10. Guyatt, G, Osoba, D, Wu, A, Wyrwich, K, Norman, G. Methods to explain the clinical significance of health status measures. Mayo Clin Proc. 2002;77:371383.Google Scholar
11. Juniper, E, Guyatt, G, Willan, A, Griffith, L. Determining a minimally important change in a disease-specific quality of life questionnaire. J Clin Epidemiol. 1994;47:8187.CrossRefGoogle Scholar
12. Juniper, E, Guyatt, G, Feeny, D, et al. Measuring quality of life in children with asthma. Qual Life Res. 1996;5:3546.CrossRefGoogle ScholarPubMed
13. Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159174.Google Scholar
14. Naughton, MJ, Shumaker, SA, Anderson, RT, Czajkawski, SM. Psychological aspects of health-related quality of life measurement: Tests and scales. In: Spilker, B, ed. Quality of life and pharmacoeconomics in clinical trials. 2nd ed. Philadelphia: Lippincott-Raven Press; 1996;121122.Google Scholar
15. Norman, G. Hi! How are you? Response shift, implicit theories and differing epistemologies. Qual Life Res. 2003;12:239249.Google Scholar
16. Oken, MM, Creech, RH, Tormey, DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649655.Google Scholar
17. Osoba, D, Rodrigues, G, Myles, J, Zee, B, Pater, J. Interpreting the significance of changes in health-related quality of life scores. J Clin Oncol. 1998;16:139140.CrossRefGoogle ScholarPubMed
18. Reddy, S, Bruera, E, Pace, E, Zhang, K, Reyes-Gibby, C. Clinically important improvement in the intensity of fatigue in patients with advanced cancer. J Palliat Med. 2007;10:10681075.CrossRefGoogle ScholarPubMed
19. Ross, DC, Kolotkin, RL, Williams, GR. Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol. 2003;56:395407.Google Scholar
20. SAS Institute. SAS Software Release 8.12 version. Cary, NC: SAS Institute.Google Scholar
21. Smith, P. The role of the general health questionnaire in general practice consultations. Br J Gen Pract. 1998;48:15651569.Google Scholar
22. Stone, P, Richardson, A, Ream, E, et al. Cancer-related fatigue: Inevitable, unimportant and untreatable? Results of a multi-centre patient survey. Ann Oncol. 2000;11:971975.Google Scholar
Supplementary material: File

Santana supplementary boxes

Santana supplementary boxes

Download Santana supplementary boxes(File)
File 29.7 KB