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Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement.

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Title: Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement.
Authors: Hoerger, Michael (AUTHOR), Gramling, Robert (AUTHOR), Epstein, Ronald (AUTHOR), Fenton, Joshua J. (AUTHOR), Mohile, Supriya G. (AUTHOR), Kravitz, Richard L. (AUTHOR), Mossman, Brenna (AUTHOR), Prigerson, Holly G. (AUTHOR), Alonzi, Sarah (AUTHOR), Malhotra, Kirti (AUTHOR), Duberstein, Paul (AUTHOR)
Source: Psycho-Oncology. Jun2022, Vol. 31 Issue 6, p978-984. 7p. 4 Charts.
Subjects: Oncologists, Caregivers, Terminal care, Bereavement, Quality of life, Cancer patients, Complicated grief
Abstract: Background: Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life. Aims: We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients' future quality of life and whether these predictions are prospectively associated with end‐of‐life care and bereavement. Materials & Methods: We conducted secondary analyses of clinical trial data. Patients with advanced cancer (n = 156), caregivers (n = 156), and oncologists (n = 38) predicted patient quality of life 3 months into the future. Patients subsequently rated their quality of life 3 months later. Medical record data documented chemotherapy and emergency department (ED)/inpatient visits in the 30 days before death (n = 79 decedents). Caregivers self‐reported on depression, anxiety, grief, purpose, and regret 7‐months post‐mortem. In mixed‐effects models, patient, caregiver, and oncologist quality‐of‐life predictions at study entry were used to predict end‐of‐life care and caregiver outcomes, controlling for patients' quality of life at 3‐month follow‐up, demographic and clinical characteristics, and nesting within oncologists. Results: Caregivers (P < 0.0001) and oncologists (P = 0.001) predicted lower quality of life than what patients actually experienced. Among decedents, 24.0% received chemotherapy and 54.5% had an ED/inpatient visit. When caregivers' predictions were more negative, patients were less likely to receive chemotherapy (P = 0.028) or have an ED/inpatient visit (P = 0.033), and caregivers reported worse depression (P = 0.002), anxiety (P = 0.019), and grief (P = 0.028) and less purpose in life (P < 0.001) 7‐months post‐mortem. Conclusion: When caregivers have more negative expectations about patients' quality of life, patients receive less intensive end‐of‐life care, and caregivers report worse bereavement outcomes. [ABSTRACT FROM AUTHOR]
Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Patient, caregiver, and oncologist predictions of quality of life in advanced cancer: Accuracy and associations with end‐of‐life care and caregiver bereavement.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hoerger%2C+Michael%22&quot;&gt;Hoerger, Michael&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gramling%2C+Robert%22&quot;&gt;Gramling, Robert&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Epstein%2C+Ronald%22&quot;&gt;Epstein, Ronald&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fenton%2C+Joshua+J%2E%22&quot;&gt;Fenton, Joshua J.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mohile%2C+Supriya+G%2E%22&quot;&gt;Mohile, Supriya G.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kravitz%2C+Richard+L%2E%22&quot;&gt;Kravitz, Richard L.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mossman%2C+Brenna%22&quot;&gt;Mossman, Brenna&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Prigerson%2C+Holly+G%2E%22&quot;&gt;Prigerson, Holly G.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Alonzi%2C+Sarah%22&quot;&gt;Alonzi, Sarah&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Malhotra%2C+Kirti%22&quot;&gt;Malhotra, Kirti&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Duberstein%2C+Paul%22&quot;&gt;Duberstein, Paul&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Psycho-Oncology%22&quot;&gt;Psycho-Oncology&lt;/searchLink&gt;. Jun2022, Vol. 31 Issue 6, p978-984. 7p. 4 Charts.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Oncologists%22&quot;&gt;Oncologists&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Caregivers%22&quot;&gt;Caregivers&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Terminal+care%22&quot;&gt;Terminal care&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Bereavement%22&quot;&gt;Bereavement&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Quality+of+life%22&quot;&gt;Quality of life&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cancer+patients%22&quot;&gt;Cancer patients&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Complicated+grief%22&quot;&gt;Complicated grief&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Informed treatment decision‐making necessitates accurate prognostication, including predictions about quality of life. Aims: We examined whether oncologists, patients with advanced cancer, and caregivers accurately predict patients&#39; future quality of life and whether these predictions are prospectively associated with end‐of‐life care and bereavement. Materials &amp; Methods: We conducted secondary analyses of clinical trial data. Patients with advanced cancer (n = 156), caregivers (n = 156), and oncologists (n = 38) predicted patient quality of life 3 months into the future. Patients subsequently rated their quality of life 3 months later. Medical record data documented chemotherapy and emergency department (ED)/inpatient visits in the 30 days before death (n = 79 decedents). Caregivers self‐reported on depression, anxiety, grief, purpose, and regret 7‐months post‐mortem. In mixed‐effects models, patient, caregiver, and oncologist quality‐of‐life predictions at study entry were used to predict end‐of‐life care and caregiver outcomes, controlling for patients&#39; quality of life at 3‐month follow‐up, demographic and clinical characteristics, and nesting within oncologists. Results: Caregivers (P &lt; 0.0001) and oncologists (P = 0.001) predicted lower quality of life than what patients actually experienced. Among decedents, 24.0% received chemotherapy and 54.5% had an ED/inpatient visit. When caregivers&#39; predictions were more negative, patients were less likely to receive chemotherapy (P = 0.028) or have an ED/inpatient visit (P = 0.033), and caregivers reported worse depression (P = 0.002), anxiety (P = 0.019), and grief (P = 0.028) and less purpose in life (P &lt; 0.001) 7‐months post‐mortem. Conclusion: When caregivers have more negative expectations about patients&#39; quality of life, patients receive less intensive end‐of‐life care, and caregivers report worse bereavement outcomes. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1002/pon.5887
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        Text: English
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    Subjects:
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      – SubjectFull: Terminal care
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              Text: Jun2022
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