Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-27T05:04:59.141Z Has data issue: false hasContentIssue false

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
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.

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.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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

Akechi, T.et al. (2012). Perceived needs, psychological distress and quality of life of elderly cancer patients. Japanese Journal of Clinical Oncology, 42, 704710. doi:10.1093/jjco/hys075.CrossRefGoogle ScholarPubMed
Ambs, A., Warren, J. L., Bellizzi, K. M., Topor, M., Haffer, S. C. and Clauser, S. B. (2008). Overview of the SEER–Medicare Health Outcomes Survey linked dataset. Health Care Financing Review, 29, 521.Google ScholarPubMed
Arndt, V., Merx, H., Stegmaier, C., Ziegler, H. and Brenner, H. (2004). Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. Journal of Clinical Oncology, 22, 48294836. doi:10.1200/JCO.2004.02.018.CrossRefGoogle ScholarPubMed
Berger, N. A.et al. (2006). Cancer in the elderly. Transactions of the American Clinical and Climatological Association, 117, 147155; discussion 155–146.Google ScholarPubMed
Blank, T. O. and Bellizzi, K. M. (2008). A gerontologic perspective on cancer and aging. Cancer, 112, 25692576. doi:10.1002/cncr.23444.CrossRefGoogle ScholarPubMed
Bretscher, M.et al. (1999). Quality of life in hospice patients. A pilot study. Psychosomatics, 40, 309313. doi:10.1016/S0033-3182(99)71224-7.CrossRefGoogle ScholarPubMed
Cella, D. F.et al. (1993). The functional assessment of cancer therapy scale: development and validation of the general measure. Journal of Clinical Oncology, 11, 570579.CrossRefGoogle ScholarPubMed
Clark, M. M.et al. (2013). Randomized controlled trial of maintaining quality of life during radiotherapy for advanced cancer. Cancer, 119, 880887. doi:10.1002/cncr.27776.CrossRefGoogle ScholarPubMed
Curran, S. L., Andrykowski, M. A. and Studts, J. L. (1995). Short Form of the Profile of Mood States (POMS-SF): psychometric information. Psychological Assessment, 7, 8083. doi:10.1037/1040-3590.7.1.80.CrossRefGoogle Scholar
Howlader, N.et al. (2012). SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations). Bethesda, MD: National Cancer Institute.Google Scholar
Koo, K.et al. (2012). Do elderly patients with metastatic cancer have worse quality of life scores? Supportive Care in Cancer, 20, 21212127. doi:10.1007/s00520-011-1322-6.CrossRefGoogle ScholarPubMed
Lapid, M. I.et al. (2007). Improving the quality of life of geriatric cancer patients with a structured multidisciplinary intervention: a randomized controlled trial. Palliative and Supportive Care, 5, 107114.CrossRefGoogle ScholarPubMed
Locke, D. E.et al. (2007). Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients. Journal of Pain and Symptom Management, 34, 628638. doi:10.1016/j.jpainsymman.2007.01.016.CrossRefGoogle ScholarPubMed
Mantovani, G.et al. (1996). Evaluation by multidimensional instruments of health-related quality of life of elderly cancer patients undergoing three different “psychosocial” treatment approaches. A randomized clinical trial. Supportive Care in Cancer, 4, 129140.CrossRefGoogle ScholarPubMed
McNair, D., Lorr, M. and Droppelman, L. (1971). Profile of Mood States: Manual. San Diego, CA: Educational and Testing Service.Google Scholar
Murphy, S. L., Xu, J. and Kochanek, K. D. (2012). National Vital Statistics Reports: Deaths: Preliminary Data for 2010. Hyattsville, MD: National Center for Health Statistics.Google Scholar
Muss, H. B. (2009). Cancer in the elderly: a societal perspective from the United States. Clinical Oncology, 21, 9298. doi:10.1016/j.clon.2008.11.008.CrossRefGoogle ScholarPubMed
Newell, S. A., Sanson-Fisher, R. W. and Savolainen, N. J. (2002). Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. Journal of the National Cancer Institute, 94, 558584.CrossRefGoogle ScholarPubMed
Northouse, L. L.et al. (2012). Randomized clinical trial of a brief and extensive dyadic intervention for advanced cancer patients and their family caregivers. Psychooncology, 22, 555–63. doi:10.1002/pon.3036.CrossRefGoogle ScholarPubMed
Pocock, S. J. and Simon, R. (1975). Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics, 31, 103115.CrossRefGoogle ScholarPubMed
Puts, M. T.et al. (2011). Quality of life during the course of cancer treatment in older newly diagnosed patients. Results of a prospective pilot study. Annals of Oncology, 22, 916923. doi:10.1093/annonc/mdq446.CrossRefGoogle ScholarPubMed
Raingruber, B. (2011). The effectiveness of psychosocial interventions with cancer patients: an integrative review of the literature (2006–2011). ISRN Nursing, 2011, 638218. doi:10.5402/2011/638218.CrossRefGoogle ScholarPubMed
Reeve, B. B.et al. (2009). Impact of cancer on health-related quality of life of older Americans. Journal of the National Cancer Institute, 101, 860868. doi:10.1093/jnci/djp123.CrossRefGoogle ScholarPubMed
Rehse, B. and Pukrop, R. (2003). Effects of psychosocial interventions on quality of life in adult cancer patients: meta analysis of 37 published controlled outcome studies. Patient Education and Counseling, 50, 179186. doi:S0738399102001490.CrossRefGoogle ScholarPubMed
Rose, J. H., Radziewicz, R., Bowmans, K. F. and O’Toole, E. E. (2008). A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer. Clinical Interventions in Aging, 3, 7795.CrossRefGoogle ScholarPubMed
Rummans, T. A.et al. (2006). Impacting quality of life for patients with advanced cancer with a structured multidisciplinary intervention: a randomized controlled trial. Journal of Clinical Oncology, 24, 635642. doi:10.1200/JCO.2006.06.209.CrossRefGoogle ScholarPubMed
Schmidt, C. E., Bestmann, B., Kuchler, T., Longo, W. E. and Kremer, B. (2005). Impact of age on quality of life in patients with rectal cancer. World Journal of Surgery, 29, 190197. doi:10.1007/s00268-004-7556-4.CrossRefGoogle ScholarPubMed
Vincent, G. K. and Velkoff, V. A. (2010). The Next Four Decades: The Older Population in the United States: 2010 to 2050 (Current Population Reports). Washington, DC: U.S. Census Bureau.Google Scholar
Wenzel, L. B.et al. (1999). Age-related differences in the quality of life of breast carcinoma patients after treatment. Cancer, 86, 17681774.3.0.CO;2-O>CrossRefGoogle ScholarPubMed