Conformance with supportive care quality measures is associated with better quality of life in patients with cancer receiving palliative care.
OBJECTIVE
As palliative care further integrates into cancer care, descriptions of how supportive care quality measures improve patient outcomes are necessary to establish best practices.


METHODS
We assessed the relationship between conformance to 18 palliative care quality measures and quality of life from data obtained using our novel point-of-care, electronic quality monitoring system, the Quality Data Collection Tool for Palliative Care (QDACT-PC). All patients with cancer from January 2008 through March 2011 seen in the Carolinas Palliative Care Consortium were evaluated for demographic, disease, prognostic, performance status, and measure conformance variables. Using univariate and multivariate regression, we examined the relationship between these variable and high quality of life at the initial specialty palliative care consultation.


RESULTS
Our cohort included 459 patients, the majority of whom were over age 65 years (66%) and white (84%). Lung (29.1%) and GI (24.7%) cancers were most common. In univariate analyses, conformance to assessment of comprehensive symptoms, fatigue and constipation assessment, timely management of pain and constipation, and timely emotional well-being assessment were associated with highest levels of quality of life (all Ps < .05). In a multivariate model (C-stat = 0.66), performance status (odds ratio [OR], 5.21; P = .003), estimated life expectancy (OR, 22.6; P = .003), conformance to the measure related to emotional well-being assessment (OR, 1.60; P = .026), and comprehensive screening of symptoms (OR, 1.74, P = .008) remained significant.


CONCLUSIONS
Oncology care pathways that routinely incorporate supportive care principles, such as comprehensive symptom and emotional well-being assessments, may improve patient outcomes.
Duke Cancer Institute, Duke University Medical Center, Durham, NC 27710, USA. arif.kamal@duke.edu
Arif H
AH
Kamal
Janet
J
Bull
Charles S
CS
Stinson
Debra L
DL
Blue
Amy P
AP
Abernethy
D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D016017:Odds Ratio; D010166:Palliative Care / Q000592:standards*; D011785:Quality Assurance, Health Care; D011788:Quality of Life