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Impact of a structured multidisciplinary intervention on quality of life of older adults with advanced cancer

Published online by Cambridge University Press:  04 September 2013

Megan M. Chock ,
Maria I. Lapid ,
Pamela J. Atherton ,
Simon Kung ,
Jeff A. Sloan ,
Jarrett W. Richardson ,
Matthew M. Clark  and
Teresa A. Rummans
Megan M. Chock
Affiliation:
Mayo Medical School, Rochester, MN 55905, USA
Maria I. Lapid*
Affiliation:
Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN 55905, USA
Pamela J. Atherton
Affiliation:
Mayo Clinic Department of Health Science Research, Division on Biomedical Statistics and Informatics, Rochester, MN 55905, USA
Simon Kung
Affiliation:
Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN 55905, USA
Jeff A. Sloan
Affiliation:
Mayo Clinic Department of Health Science Research, Division on Biomedical Statistics and Informatics, Rochester, MN 55905, USA
Jarrett W. Richardson
Affiliation:
Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN 55905, USA
Matthew M. Clark
Affiliation:
Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN 55905, USA
Teresa A. Rummans
Affiliation:
Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN 55905, USA
*
Correspondence should be addressed to: Maria I. Lapid, Mayo Clinic Department of Psychiatry and Psychology, 200 First Street SW, Rochester, MN 55905, USA. Phone: +1-507-284-2511; Fax: +1-507-284-4158. Email: lapid.maria@mayo.edu.
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Abstract

Background:

Patients experience reductions in quality of life (QOL) while receiving cancer treatment and several approaches have been proposed to address QOL issues. In this project, the QOL differences between older adult (age 65+) and younger adult (age 18–64) advanced cancer patients in response to a multidisciplinary intervention designed to improve QOL were examined.

Methods:

This study was registered on ClinicalTrials.gov, NCT01360814. Newly diagnosed advanced cancer patients undergoing radiation therapy were randomized to active QOL intervention or control groups. Those in the intervention group received six multidisciplinary 90-minute sessions designed to address the five major domains of QOL. Outcomes measured at baseline and weeks 4, 27, and 52 included QOL (Linear Analogue Self-Assessment (LASA), Functional Assessment of Cancer Therapy–General (FACT-G)) and mood (Profile of Mood States (POMS)). Kruskall–Wallis methodology was used to compare scores between older and younger adult patients randomized to the intervention.

Results:

Of 131 patients in the larger randomized controlled study, we report data on 54 evaluable patients (16 older adults and 38 younger adults) randomized to the intervention. Older adult patients reported better overall QOL (LASA 74.4 vs. 62.9, p = 0.040), higher social well-being (FACT-G 91.1 vs. 83.3, p = 0.045), and fewer problems with anger (POMS anger–hostility 95.0 vs. 86.4, p = 0.028). Long-term benefits for older patients were seen in the anger–hostility scale at week 27 (92.2 vs. 84.2, p = 0.027) and week 52 (96.3 vs. 85.9, p = 0.005).

Conclusions:

Older adult patients who received a multidisciplinary intervention to improve QOL while undergoing advanced cancer treatments benefited differently in some QOL domains, compared to younger adult patients. Future studies can provide further insight on how to tailor QOL interventions for these age groups.

Keywords

well-beingmoodelderlypsycho-oncologypsychosocialmultidisciplinary intervention
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 12 , December 2013 , pp. 2077 - 2086
Copyright
Copyright © International Psychogeriatric Association 2013 

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