
DOI: 10.1055/s-0040-1703420
Assessing the Quality of Life of Filipino Cancer Patients: A Survey of Filipino Oncologists

Abstract
Introduction Recent trials of new drugs have placed much emphasis on survival. However, several guidelines have emphasized the need for assessing health-related quality of life (HRQoL) as part of the holistic approach in the management of cancer patients. There are currently no national governing guidelines and no existing data on the status of HRQoL assessments by Filipino oncologists, thus this study.
Study Design This was a cross-sectional study that utilized a validated questionnaire. Descriptive and multivariate analyses were used to analyze the data.
Results A total of 312 oncologists participated in this study. Majority were medical oncologists (41%), followed by radiation oncologists (25%), hematologists (14%), gynecologic oncologists (12%), and surgical oncologists (8%). About 96% reported that HRQoL assessment was important for clinical work; however, 58% perceived HRQoL to be a vague term and 55% felt they were insufficiently trained to assess HRQoL. About 89% reported that they will be more confident if local HRQoL assessment guidelines will be present, and 93% agreed to the use of a unified HRQoL assessment tool for Filipino cancer patients. About 85% thought that the optimal number of questions for a HRQoL assessment tool should be between 5 and 15 questions. The significant predictors of HRQoL assessment among oncologists were field of oncology and years in practice/training (p < 0.05).
Conclusion Filipino oncologists perceived HRQoL patient assessments to be important in clinical practice. However, majority did not know which tool to use and did not feel sufficiently trained to assess HRQoL. The creation of a practice guideline that would facilitate the use of a unified HRQoL assessment tool for Filipino cancer patients is highly recommended.
Publication History
Publication Date:
22 February 2020 (online)
© .
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
References
- 1 World Health Organization. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19 June–22 July 1946. Available at: http://whqlibdoc.who.int/hist/official_records/constitution.pdf. Accessed on February 10, 2020
- 2 Ngelangel CA. Quality of life of Filipino cancer patients. Asia Pac J Oncol Haematol 2008; 1 (01) 18-19
- 3 Knobel H, Håvard Loge J, Lund MB, Forfang K, Nome O, Kaasa S. Late medical complications and fatigue in Hodgkin’s disease survivors. J Clin Oncol 2001; 19 (13) 3226-3233
- 4 Bezjak A, Ng P, Skeel R, Depetrillo AD, Comis R, Taylor KM. Oncologists’ use of quality of life information: results of a survey of Eastern Cooperative Oncology Group physicians. Qual Life Res 2001; 10 (01) 1-13
- 5 Laudico AV, Mirasol-Lumague MR, Medina V, Mapua CA, Valenzuela FG, Pukkala E. Philippine Cancer Facts and Estimates 2015. Philippine Cancer Society 2015. Available at: http://www.philcancer.org.ph/wp-content/uploads/2017/07/2015-PCS-Ca-Facts-Estimates_CAN090516.pdf. Accessed on February 10, 2020
- 6 EORTC. Quality of Life Department. Available at: https://www.eortc.org/research_field/quality-of-life/. Accessed on February 13, 2020
- 7 ESMO. Available at: http://esmo.org. Accessed on February 13, 2020
- 8 Gyawali B, Hwang T. Prevalence of quality of life (QoL) outcomes and association with survival in cancer clinical trials. J Clin Oncol 2018; 36 Suppl 6573
- 9 Higginson IJ, Carr AJ. Measuring quality of life: using quality of life measures in the clinical setting. BMJ 2001; 322 7297 1297-1300
- 10 Ramiro LS, Ngelangel CA, Amarillo ML. The UP-DOH QOL scale: measures of quality of life of Filipino cancer patients. Philipp J Intern Med 1997; (July–August) 179-188
- 11 Chang VT, Thaler HT, Polyak TA, Kornblith AB, Lepore JM, Portenoy RK. Quality of life and survival: the role of multidimensional symptom assessment. Cancer 1998; 83 (01) 173-179
- 12 Bottomley A. The cancer patient and quality of life. Oncologist 2002; 7 (02) 120-125
- 13 Spilker B. Ed. Quality of Life and Pharmacoeconomics in Clinical Trials. 2nd edition. New York: Raven Press; 1996: 1-10
- 14 Varricchio CG, McCabe MS, Trimble E, Korn EL. Quality of life in clinical cancer trials. Introduction. J Natl Cancer Inst Monogr 1996; 20 (20) vii-viii
- 15 Osoba D. Lessons learned from measuring health-related quality of life in oncology. J Clin Oncol 1994; 12 (03) 608-616
- 16 Feld R. Endpoints in cancer clinical trials: is there a need for measuring quality of life?. Support Care Cancer 1995; 3 (01) 23-27
- 17 Stephens RJ, Hopwood P, Girling DJ, Machin D. Randomized trials with quality of life endpoints: are doctors’ ratings of patients’ physical symptoms interchangeable with patients’ self-ratings?. Qual Life Res 1997; 6 (03) 225-236
- 18 Titzer ML, Fisch M, Kristellar JL. et al. Clinician’s assessment of quality of life (QOL) in outpatients with advanced cancer: how accurate is our prediction? A Hoosier oncology study. Am Soc Clin Oncol 2001; 20: 384a
- 19 Green SB. Does assessment of quality of life in comparative cancer trials make a difference? A discussion. Control Clin Trials 1997; 18 (04) 306-310
- 20 Kong SX, Gandhi SK. Methodologic assessments of quality of life measures in clinical trials. Ann Pharmacother 1997; 31 (7-8) 830-836
- 21 Smith KW, Avis NE, Assmann SF. Distinguishing between quality of life and health status in quality of life research: a meta-analysis. Qual Life Res 1999; 8 (05) 447-459
- 22 Juniper EF, Guyatt GH, Willan A, Griffith LE. Determining a minimal important change in a disease-specific Quality of Life Questionnaire. J Clin Epidemiol 1994; 47 (01) 81-87
- 23 Osoba D, Rodrigues G, Myles J, Zee B, Pater J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 1998; 16 (01) 139-144
- 24 Kramer JA, Curran D, Piccart M. et al. Identification and interpretation of clinical and quality of life prognostic factors for survival and response to treatment in first-line chemotherapy in advanced breast cancer. Eur J Cancer 2000; 36 (12) 1498-1506
- 25 Staquet M, Berzon R, Osoba D, Machin D. Guidelines for reporting results of quality of life assessments in clinical trials. Qual Life Res 1996; 5 (05) 496-502
- 26 van Knippenberg FC, de Haes JC. Measuring the quality of life of cancer patients: psychometric properties of instruments. J Clin Epidemiol 1988; 41 (11) 1043-1053
- 27 Schumacher M, Olschewski M, Schulgen G. Assessment of quality of life in clinical trials. Stat Med 1991; 10 (12) 1915-1930
- 28 WHOQOL Group. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 1993; 2 (02) 153-159
- 29 Schmick A, Juergensen M, Rohde V, Katalinic A, Waldmann A. Assessing health-related quality of life in urology - a survey of 4500 German urologists. BMC Urol 2017; 17 (01) 46-58
- 30 Donnelly S. Quality-of-life assessment in advanced cancer. Curr Oncol Rep 2000; 2 (04) 338-342
- 31 Jacobsen PB, Davis K, Cella D. Assessing quality of life in research and clinical practice. Oncology (Williston Park) 2002; 16 (09) (Suppl. 10) 133-139
- 32 Rattray J, Jones MC. Essential elements of questionnaire design and development. J Clin Nurs 2007; 16 (02) 234-243
- 33 Marsden PV, Writh JD. Handbook of Survey Research. 2nd edition. Connecticut: Emerald Books; 2010
- 34 Philippine Health Ethics Research Board. National Ethical Guidelines for Health and Health-related Research 2017. Taguig City, Philippines 2017. Available at: http://www.ethics.healthresearch.ph/index.php/phoca-downloads/category/4-neg. Accessed on February 10, 2020
- 35 AgarwalNK. Verifying survey items for construct validity: a two-stage sorting procedure for questionnaire design in information behaviour research (annual meeting conference proceedings). Association for Information Science and Technology, 2011. Available at: https://asistdl.onlinelibrary.wiley.com/doi/epdf/10.1002/meet.2011.14504801166. Accessed on February 10, 2020
- 36 Baars RM, van der Pal SM, Koopman HM, Wit JM. Clinicians’ perspective on quality of life assessment in paediatric clinical practice. Acta Paediatr 2004; 93 (10) 1356-1362
- 37 Skevington SM, Day R, Chisholm A, Trueman P. How much do doctors use quality of life information in primary care? Testing the trans-theoretical model of behaviour change. Qual Life Res 2005; 14 (04) 911-922
- 38 Velikova G, Awad N, Coles-Gale R, Wright EP, Brown JM, Selby PJ. The clinical value of quality of life assessment in oncology practice-a qualitative study of patient and physician views. Psychooncology 2008; 17 (07) 690-698
- 39 Velikova G, Booth L, Smith AB. et al. Measuring quality of life in routine oncology practice improves communication and patient well-being: a randomized controlled trial. J Clin Oncol 2004; 22 (04) 714-724
- 40 Straus SE, Sackett DL. Using research findings in clinical practice. BMJ 1998; 317 7154 339-342
- 41 Osoba D. Health-related quality of life and cancer clinical trials. Ther Adv Med Oncol 2011; 3 (02) 57-71
- 42 Morris J, Perez D, McNoe B. The use of quality of life data in clinical practice. Qual Life Res 1998; 7 (01) 85-91
- 43 Young T, Maher J. Collecting quality of life data in EORTC clinical trials–what happens in practice. Psychooncology 1999; 8 (03) 260-263
- 44 Bossola M, Murri R, Onder G, Turriziani A, Fantoni M, Padua L. Physicians’ knowledge of health-related quality of life and perception of its importance in daily clinical practice. Health Qual Life Outcomes 2010; 8: 43-50
- 45 MAPI Research Institute. Quality of Life Assessment in Medicine. Available at: http://www.QLMed.org/index.html. Accessed on February 2, 2020
- 46 Endicott J, Nee J, Harrison W, Blumenthal R. Quality of life enjoyment and satisfaction questionnaire: a new measure. Psychopharmacol Bull 1993; 29 (02) 321-326
- 47 Sigurdardóttir V, Bolund C, Sullivan M. Quality of life evaluation by the EORTC questionnaire technique in patients with generalized malignant melanoma on chemotherapy. Acta Oncol 1996; 35 (02) 149-158
- 48 Sigurdardóttir V, Brandberg Y, Sullivan M. Criterion-based validation of the EORTC QLQ-C36 in advanced melanoma: the CIPS questionnaire and proxy raters. Qual Life Res 1996; 5 (03) 375-386
- 49 Cella DF, Tulsky DS, Gray G. et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 1993; 11 (03) 570-579
- 50 Kemmler G, Holzner B, Kopp M. et al. Comparison of two quality-of-life instruments for cancer patients: the functional assessment of cancer therapy-general and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30. J Clin Oncol 1999; 17 (09) 2932-2940
- 51 Bjordal K, Hammerlid E, Ahlner-Elmqvist M. et al. Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol 1999; 17 (03) 1008-1019
- 52 Cella DF, Tulsky DS, Gray G. et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 1993; 11 (03) 570-579
- 53 Cella DF, Bonomi AE, Lloyd SR, Tulsky DS, Kaplan E, Bonomi P. Reliability and validity of the Functional Assessment of Cancer Therapy-Lung (FACT-L) quality of life instrument. Lung Cancer 1995; 12 (03) 199-220
- 54 Aaronson NK, Ahmedzai S, Bergman B. et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85 (05) 365-376
- 55 Aaronson NK, Cull AM, Kaasa S, Sprangers MAG. The European Organization for Research and Treatment of Cancer (EORTC) modular approach for quality of life assessment in oncology: an update. In: Spilker B. ed. Quality of Life and Pharmacoeconomics in Clinical Trials. 2nd edition. Philadelphia: Lippincott-Raven; 1996: 179-189
- 56 Higginson IJ, Carr AJ. The clinical utility of quality of life measures. In: Carr AJ, Higginson IJ, Robinson PG. eds. Quality of Life. BMJ Books; London: 2003: 63-78
- 57 Coates A, Porzsolt F, Osoba D. Quality of life in oncology practice: prognostic value of EORTC QLQ-C30 scores in patients with advanced malignancy. Eur J Cancer 1997; 33 (07) 1025-1030
- 58 Efficace F, Bottomley A, Coens C. et al. Does a patient’s self-reported health-related quality of life predict survival beyond key biomedical data in advanced colorectal cancer?. Eur J Cancer 2006; 42 (01) 42-49
- 59 Gotay CC, Kawamoto CT, Bottomley A, Efficace F. The prognostic significance of patient-reported outcomes in cancer clinical trials. J Clin Oncol 2008; 26 (08) 1355-1363
- 60 Ediebah DE, Coens C, Zikos E. et al. Does change in health-related quality of life score predict survival? Analysis of EORTC 08975 lung cancer trial. Br J Cancer 2014; 110 (10) 2427-2433
- 61 Quinten C, Coens C, Mauer M. et al. EORTC Clinical Groups. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol 2009; 10 (09) 865-871
- 62 Quinten C, Martinelli F, Coens C. et al. Patient Reported Outcomes and Behavioral Evidence (PROBE) and the European Organization for Research and Treatment of Cancer (EORTC) Clinical Groups. A global analysis of multitrial data investigating quality of life and symptoms as prognostic factors for survival in different tumor sites. Cancer 2014; 120 (02) 302-311
- 63 van Nieuwenhuizen AJ, Buffart LM, Brug J, Leemans CR, Verdonck-de Leeuw IM. The association between health related quality of life and survival in patients with head and neck cancer: a systematic review. Oral Oncol 2015; 51 (01) 1-11
- 64 Johnson C, Aaronson N, Blazeby JM, et al. Guidelines for developing Quality of Life Questionnaires. http://groups.eortc.be/qol/sites/default/files/archives/guidelines_for_developing_ questionnaire-_final.pdf. Brussels: EORTC Publications; 2011. Accessed May 26, 2015
- 65 Ediebah DE, Coens C, Maringwa JT. et al. Gastro-Intestinal Tract Cancer Cooperative Group;, Lung Cancer Cooperative Group; , Quality of Life Department and Patient Reported Outcome and Behavioural Evidence (PROBE). Effect of completion-time windows in the analysis of health-related quality of life outcomes in cancer patients. Ann Oncol 2013; 24 (01) 231-237
- 66 Pater J, Osoba D, Zee B. et al. Effects of altering the time of administration and the time frame of quality of life assessments in clinical trials: an example using the EORTC QLQ-C30 in a large anti-emetic trial. Qual Life Res 1998; 7 (03) 273-278
- 67 Bezjak A, Taylor KM, Ng P, Macdonald K, DePetrillo AD. Quality-of-life information and clinical practice: the oncologist’s perspective. Cancer Prev Control 1998; 2 (05) 230-235
- 68 McLachlan SA, Allenby A, Matthews J. et al. Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol 2001; 19 (21) 4117-4125
- 69 Velikova G, Wright P, Smith AB. et al. Self-reported quality of life of individual cancer patients: concordance of results with disease course and medical records. J Clin Oncol 2001; 19 (07) 2064-2073
- 70 Goyal U, Ong S, Cheung MK. et al. Assessment of symptom burden and quality of life in radiation oncology patients. Int J Radiat Oncol Biol Phys 2015; 93 (03) E491
- 71 Scott CB, Stetz J, Bruner DW, Wasserman TH. Radiation Therapy Oncology Group quality of life assessment: design, analysis, and data management issues. Qual Life Res 1994; 3 (03) 199-206
- 72 Institute of Medicine (US) Council on Health Care Technology. Mosteller F, Falotico-Taylor J. eds. Quality of Life and Technology Assessment: Monograph of the Council on Health Care Technology. Washington (DC): National Academies Press (US); 1989
- 73 Rodriguez KL, Bayliss N, Alexander SC. et al. How oncologists and their patients with advanced cancer communicate about health-related quality of life. Psychooncology 2010; 19 (05) 490-499
- 74 O’leary MP. Validity of the “bother score” in the evaluation and treatment of symptomatic benign prostatic hyperplasia. Rev Urol 2005; 7 (01) 1-10
- 75 Litwin MS, Lubeck DP, Henning JM, Carroll PR. Differences in urologist and patient assessments of health related quality of life in men with prostate cancer: results of the CaPSURE database. J Urol 1998; 159 (06) 1988-1992