Enhanced supportive care: prospective cohort study of oncology patients and caregivers
Taylor, Sally Vercell, Amy Sawyer, Chelsea Khatoon, Binish Coomber-Moore, Jake Yorke, Janelle Mula, Carole Berman, Richard
Taylor, Sally
Vercell, Amy
Sawyer, Chelsea
Khatoon, Binish
Coomber-Moore, Jake
Yorke, Janelle
Mula, Carole
Berman, Richard
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Abstract
Objectives: A prospective cohort study to evaluate clinical effectiveness of the enhanced supportive care (ESC) service at a comprehensive cancer centre and to explore the impact of the service on patient and caregiver outcomes and experience.
Methods: Patients who received care under the ESC service and their caregivers were eligible. Consented patients (n=184) and caregivers (n=67) completed questionnaires at baseline, 4 weeks and 8 weeks post-ESC. Patient questionnaires assessed quality of life (QOL), symptoms, experience of ESC and health service use. Caregiver questionnaires included QOL and needs assessment. Selected patients (n=13) participated in qualitative interviews. Quantitative analysis explored differences in questionnaire responses over time (p<0.05). Qualitative data were analysed thematically.
Results: Patient quantitative data showed improvements in QOL (p=0.004 for European Quality of Life Questionnaire 5 dimensions (EQ5D) health index scores) and anxiety (p=0.006) at 4 weeks, reduction in some symptoms (pain p=0.02 at 4 weeks), improvement in self-efficacy, an increase in problems being addressed and a decrease in health service use (reduction in outpatient appointments). Qualitative findings suggested patients were generally satisfied with the ESC service but identified areas for improvement such as increased awareness of ESC and earlier referral. Fewer improvements were noted for caregivers; however, they did report a decrease in unmet needs.
Conclusion: The ESC service had a positive impact on various patient-reported and caregiver-reported outcomes. There were also positive impacts on health service use. Increasing awareness of ESC and engaging patients at an earlier stage in the disease trajectory may further improve patient satisfaction and outcomes.
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Date
2023
Publisher
Collections
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Type
Article
Citation
Taylor S, Vercell A, Sawyer C, Khatoon B, Coomber-Moore J, Yorke J, et al. Enhanced supportive care: prospective cohort study of oncology patients and caregivers. BMJ supportive & palliative care. 2023 Sep 11. PubMed PMID: 37696586. Epub 2023/09/12. eng.