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Randomized Controlled Trial
. 2021 Sep;278(9):3435-3449.
doi: 10.1007/s00405-020-06533-3. Epub 2020 Dec 21.

Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: main results of a cluster preference randomised controlled trial

Simon N Rogers  1   2 , Christine Allmark  3 , Fazilet Bekiroglu  4 , Rhiannon Tudor Edwards  5 , Gillon Fabbroni  3 , Robert Flavel  6 , Victoria Highet  7 , Michael W S Ho  3 , Gerald M Humphris  8 , Terry M Jones  9 , Owais Khattak  4 , Jeffrey Lancaster  4 , Christopher Loh  4 , Derek Lowe  10 , Cher Lowies  7 , Dominic Macareavy  11 , James Moor  3 , T K Ong  3 , A Prasai  3 , Nicholas Roland  4 , Cherith Semple  12   13 , Llinos Haf Spencer  5 , Sank Tandon  4 , Steven J Thomas  14 , Andrew Schache  4 , Richard J Shaw  4 , Anastasios Kanatas  3
Affiliations
Randomized Controlled Trial

Improving quality of life through the routine use of the patient concerns inventory for head and neck cancer patients: main results of a cluster preference randomised controlled trial

Simon N Rogers et al. Eur Arch Otorhinolaryngol. 2021 Sep.

Abstract

Purpose: The patient concerns inventory (PCI) is a prompt list allowing head and neck cancer (HNC) patients to discuss issues that otherwise might be overlooked. This trial evaluated the effectiveness of using the PCI at routine outpatient clinics for one year after treatment on health-related QOL (HRQOL).

Methods: A pragmatic cluster preference randomised control trial with 15 consultants, 8 'using' and 7 'not using' the PCI intervention. Patients treated with curative intent (all sites, disease stages, treatments) were eligible.

Results: Consultants saw a median (inter-quartile range) 16 (13-26) patients, with 140 PCI and 148 control patients. Of the pre-specified outcomes, the 12-month results for the mean University of Washington Quality of Life (UW-QOLv4) social-emotional subscale score suggested a small clinical effect of intervention of 4.6 units (95% CI 0.2, 9.0), p = 0.04 after full adjustment for pre-stated case-mix. Results for UW-QOLv4 overall quality of life being less than good at 12 months (primary outcome) also favoured the PCI with a risk ratio of 0.83 (95% CI 0.66, 1.06) and absolute risk 4.8% (- 2.9%, 12.9%) but without achieving statistical significance. Other non-a-priori analyses, including all 12 UWQOL domains and at consultant level also suggested better HRQOL with PCI. Consultation times were unaffected and the number of items selected decreased over time.

Conclusion: This novel trial supports the integration of the PCI approach into routine consultations as a simple low-cost means of benefiting HNC patients. It adds to a growing body of evidence supporting the use of patient prompt lists more generally.

Keywords: Head and neck cancer; Intervention; Patient concerns inventory; Patient-reported outcomes; Quality of life; Randomised trial.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. We do not have financial disclosure or any conflict of interest.

Figures

Fig. 1
Fig. 1
Patient flow from trial baseline to final clinic
Fig. 2
Fig. 2
PCI items selected at baseline, intermediate and final clinics
See this image and copyright information in PMC

References

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