1375P - Living better or living longer? Perceptions of patients (pts) and health care professionals (HCP) in oncology

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Psychosocial Aspects of Cancer
Presenter Diego Toloi
Citation Annals of Oncology (2014) 25 (suppl_4): iv481-iv485. 10.1093/annonc/mdu352
Authors D.A. Toloi1, G. Critchi2, A. Mangabeira2, P.M. Hoff1, F. Matsushita3, E.D. Saad2, R.P. Riechelmann1
  • 1Oncologia Clínica - 5º Andar, ICESP - Instituto do Câncer do Estado de São Paulo, 01246-000 - São Paulo/BR
  • 2Dendrix Research, Ltd., Dendrix Research, Ltd., 04534000 - São Paulo/BR
  • 3Fmusp - Faculdade De Medicina Da Universidade De São Paulo, FMUSP - Faculdade de Medicina da Universidade de São Paulo, 01246903 - São Paulo/BR

Abstract

Aim

Cancer diagnosis can impact the view of pts and HCP on treatment goals. Therefore, it is crucial to understand their expectations in terms of how aggressive the oncologic approach should be in order to preserve survival time (ST) and/or quality of life (QOL).

Methods

We performed a cross-sectional survey of cancer pts and HCP to evaluate their perceptions about treatment priorities and to analyze variables that might influence their opinions. A structured questionnaire with fictitious case vignettes was developed to identify treatment choices. Comparisons between groups were made using Fisher's exact test or the Mann-Whitney test, as appropriate and logistic regression (LR) was used to explore priorities for ST.

Results

From Jan/2013 to Mar/2014 N = 240 participants were enrolled with 144 pts and 86 HCP (35 nurses, 21 physicians, 30 others). The group of pts had a higher median age (53 vs 29 y; P < 0.01) and a lower proportion of females (59.7% vs 74.4%; P = 0.03) than the group of HCP. Pts had gastrointestinal (40.3%), breast (20.8%), lung (6.9%), and other tumors (31.9%), and TNM stages were I/II/III/IV/unknown in 1.4/8.3/30.6/58.3/1.4%. Treatment priority were ST/QOL/Uncertain or unwilling to respond/Invalid response were 28.5/45.8/20.1/5.6% for pts vs 8.1/87.2/3.5/1.2% for HCP (P < 0.01). In multivariate LR, prioritizing ST was more frequent in pts than in the HCP, adjusting for age and gender (odds ratio 3.95; P < 0.01). Among pts, prioritizing ST did not differ significantly between TNM stages I to III vs IV. Among HCP, prioritizing ST did not differ significantly among nurses, physicians, and others. The statement that the physician alone should be responsible for treatment choices was more frequent among pts than HCP (18.8 vs 5.8%; P = 0.01).

Conclusions

In Brazil, our results suggest that ST is more important for cancer pts than for HCP, whereas QOL is more important in HCP than in cancer pts, who seem to place more emphasis on physicians alone as decision-makers than HCP. These results are important to understand the expectations of pts and HCP. Because Brazilian pts often rely on physicians for decisions, the impact on treatment choices of different priorities when pts and HCP are compared is unknown.

Disclosure

All authors have declared no conflicts of interest.