A Pilot Study to Assess the Integration of a Unique PROQOL Tool and Early Palliative Care Intervention in the Care of High Grade Glioma Patients and their Caregivers (2633)

Document Type

Article

Publication Date

4-14-2020

Publication Title

Neurology

Keywords

california; sjci

Abstract

Objective: Appraise the feasibility of a novel patient reported outcomes (PRO) quality of life (QOL) tool administered by smart device in routine office visits (OV) and of early integration of palliative care (PC) for pwHGG and caregivers to improve QOL for both.

Background: Early involvement of palliative care (PC) in patients with metastatic cancer has been associated with improved quality of life (QOL). Patients with high grade glioma (pwHGG) and their caregivers have unique needs such that similar results are anticipated in this population but cannot be extrapolated. Recognizing that pwHGG often require a caregiver early in the course of disease, this patient population also experiences significant personal and caregiver distress that has been given limited attention and resources.

Design/Methods: Prospective, single-center cluster-randomized pilot conducted for 6 months during completion of adjuvant therapy for newly diagnosed high grade glioma. After informed consent was obtained, 15 pwHGG and their caregivers were randomized to: routine OV with basic QOL survey; OV with PROQOL; or PC consultation, in addition to OV with PROQOL.

Results: All clusters have completed the study at this time. Two elderly patients with declining performance status transitioned to hospice after initial visit, two moved out of state prior to adjuvant visits, one withdrew due to appointment burden and one withdrew after an infection complication. The PROQOL appears to be easily integrated into OV without significant patient, caregiver, or provider burden. Providers confirmed utility in prioritizing symptoms and concerns. Thus far, it appears that patients (and caregivers) appeared to benefit from the PROQOL and PC support as evidenced by longitudinal improvement in QOL scores over the control group.

Conclusions: A unique PROQOL tool and early PC may be easily integrated into practice, and may improve the QOL of pwHGG and their caregivers. Challenges include appointment burden and costs related to PC.

Clinical Institute

Neurosciences (Brain & Spine)

Clinical Institute

Cancer

Department

Neurosciences

Department

Oncology

Department

Palliative Care

Comments

Akanksha Sharma, Eric Wolfe, Celina Barrera, Samantha Williamson, Hannah Farfour, Maciej Mrugala, Mark Edwin, Jeff Sloan, Alyx Porter

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