Mariëtte N Verkissen1,2, Aline De Vleminck3,4, Mogens Groenvold5,6, Lea J Jabbarian7, Francesco Bulli8, Wilfried Cools9, Johannes J M van Delden10, Urška Lunder11, Guido Miccinesi8, Sheila A Payne12, Kristian Pollock13, Judith A C Rietjens7, Luc Deliens3,4,14. 1. Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium. mariette.verkissen@vub.be. 2. Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Brussels, Belgium. mariette.verkissen@vub.be. 3. Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium. 4. Vrije Universiteit Brussel (VUB), Department of Family Medicine and Chronic Care, Brussels, Belgium. 5. University of Copenhagen, Department of Geriatrics and Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. 6. University of Copenhagen, Department of Public Health, Copenhagen, Denmark. 7. Erasmus University Medical Center, Department of Public Health, Rotterdam, Netherlands. 8. Oncological Network, Prevention and Research Institute (ISPRO), Clinical Epidemiology, Florence, Italy. 9. Vrije Universiteit Brussel (VUB), Interfaculty Center Data Processing and Statistics, Brussels, Belgium. 10. University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands. 11. University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia. 12. Lancaster University, International Observatory on End of Life Care, Division of Health Research, Lancaster, United Kingdom. 13. University of Nottingham, School of Health Sciences, Nottingham, United Kingdom. 14. Ghent University, Department of Public Health and Primary Care, Ghent, Belgium.
Abstract
BACKGROUND: People with advanced cancer often suffer from various symptoms, which can arise from the cancer itself and its treatment, the illness experience, and/or co-morbid conditions. Important patient-reported outcomes such as functional status, symptom severity, and quality of life (QoL) might differ between countries, as countries vary with regard to contextual factors such as their healthcare system. PURPOSE: To assess self-reported emotional functioning, physical functioning, symptoms, and overall QoL in patients with advanced lung or colorectal cancer from six European countries, particularly in relation to their country of residence. METHODS: We used baseline patient data from the ACTION trial, including socio-demographic and clinical data as well as patient-reported data regarding functioning, symptoms, and overall QoL (EORTC QLQ-C15-PAL). RESULTS: Data from 1117 patients (55% lung cancer stage III/IV, 45% colorectal cancer stage IV) were used. The highest (worst) average symptom score was found for fatigue. We found similarities but also important differences in the outcomes across countries. The best scores (the highest for emotional functioning and QoL, the lowest for symptoms) were reported by Dutch and Danish patients. Belgian patients reported relatively low emotional functioning. CONCLUSION: The optimization of functioning, symptom relief, and overall QoL should be important objectives of healthcare professionals who take care of patients with advanced cancer. There are similarities, but also substantial differences across countries in functional status, symptoms, and overall QoL. Policymakers should take these differences into account and invest in offering health care catered to the needs of their population.
BACKGROUND:People with advanced cancer often suffer from various symptoms, which can arise from the cancer itself and its treatment, the illness experience, and/or co-morbid conditions. Important patient-reported outcomes such as functional status, symptom severity, and quality of life (QoL) might differ between countries, as countries vary with regard to contextual factors such as their healthcare system. PURPOSE: To assess self-reported emotional functioning, physical functioning, symptoms, and overall QoL in patients with advanced lung or colorectal cancer from six European countries, particularly in relation to their country of residence. METHODS: We used baseline patient data from the ACTION trial, including socio-demographic and clinical data as well as patient-reported data regarding functioning, symptoms, and overall QoL (EORTC QLQ-C15-PAL). RESULTS: Data from 1117 patients (55% lung cancer stage III/IV, 45% colorectal cancer stage IV) were used. The highest (worst) average symptom score was found for fatigue. We found similarities but also important differences in the outcomes across countries. The best scores (the highest for emotional functioning and QoL, the lowest for symptoms) were reported by Dutch and Danish patients. Belgian patients reported relatively low emotional functioning. CONCLUSION: The optimization of functioning, symptom relief, and overall QoL should be important objectives of healthcare professionals who take care of patients with advanced cancer. There are similarities, but also substantial differences across countries in functional status, symptoms, and overall QoL. Policymakers should take these differences into account and invest in offering health care catered to the needs of their population.
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