[Prospective study on the quality of care and quality of life in advanced cancer patients treated at home or in hospital: intermediate analysis of the Trapado study]

Abstract

The preferences of advanced cancer patients and the impact of cancer management on relatives remain partly unknown. We present the preliminary results of a prospective study evaluating quality of care (QC), quality of life (QoL) and family impact (FI) in advanced cancer patients treated at home or in hospital, depending on their own choice. QC is evaluated using STAS questionnaire, and QoL and symptom control using EORTC QLQ-C30, Spielberger questionnaire and VAS for pain evaluation. FI is evaluated using GHQ28 and semi-structured interviews conducted at days 0, 15, 30, then monthly until death. Intermediate analysis of 52 patients (100 expected) of whom 63 % had chosen home care, 26 % in-hospital care. Actual assignment is home care: 56 %, in-hospital care: 44 %. Place of death is home: 15 %, hospital: 85 %. In the QC study, the two symptoms most frequently rated by nurses are anxiety and pain, in either group. Patient information and communication are also similar in both groups. The QoL and symptom study shows that patients also rate pain as frequent (84 %) but moderate (mean VAS score 2.5/10). However, the most frequent symptom is fatigue (100 %). Anxiety is rated higher at hospital, as well as FI (anxiety, insomnia, social dysfunction and global score). Palliative care research is sometimes difficult but feasible. In this study, most patients prefer home care. Anxiety and FI seem lower at home. However, re-hospitalisations just before death are frequent and death generally occurs in hospital.