title: Prevalence of cancer chemotherapy-related problems, their relation to health-related quality of life and associated supportive care: a cross-sectional survey.
abstract: The purpose of this study was to identify the treatment-associated problems that most impact on patients undergoing cancer chemotherapy, how problems relate to experiences of supportive care and variations in experience between cancer treatment centres.
  
  
  
  A survey administered to patients at six cancer centres in England explored variations of prevalence of 17 cancer chemotherapy-associated problems and associated supportive care. Problem items were identified as the most frequently experienced and severe when experienced in a scoping and consensus exercise. A health-related quality of life (HRQoL) measure, the EQ5D, was included to measure impact of problems.
  
  
  
  A total of 363 completed questionnaires were returned (response rate 43 %, median 61 %). The most prevalent problem was 'tiredness/fatigued' (90 %), followed by 'changes in taste & smell' (69 %) and 'difficulty managing everyday tasks' (61 %). Significant variations in problem prevalence existed between centres, and some common problems were rarely reported in the literature. Regression analysis found that almost all problems were significantly associated with HRQoL, with social/emotional problems having as much impact on HRQoL as physical/psychological side effects of treatment. Greatest effect size was for difficulty managing everyday tasks. Respondents reported significant variations in supportive care between centres, with more supportive care received for physical/psychological problems than for social/emotional problems. Findings indicated that patients who received increased supportive care experienced less severe problems.
  
  
  
  The most common and distressing chemotherapy-associated problems were identified. These problems are mitigated by quality supportive care. Routine measurement and monitoring of problem items and supportive care are warranted to facilitate benchmarking and service improvements both within and between cancer centres.
authors.affiliation: Faculty of Health Sciences, Highfield, University of Southampton, Southampton, UK. R.Wagland@soton.ac.uk.
authors.forename: Richard
authors.identifier: 0000-0003-1825-7587
authors.initials: R
authors.lastname: Wagland
authors.affiliation: Faculty of Health Science, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Richardson
authors.affiliation: Southampton Statistical Sciences Research Institute, Faculty of Social, Human and Mathematical Sciences, Highfield, University of Southampton, Southampton, UK.
authors.forename: Sean
authors.initials: S
authors.lastname: Ewings
authors.affiliation: Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Armes
authors.affiliation: University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Lennan
authors.affiliation: Faculty of Health Sciences, Highfield, University of Southampton, Southampton, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hankins
authors.affiliation: Faculty of Health Sciences, Highfield, University of Southampton, Southampton, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Griffiths
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cancer; Health-related quality of life (HRQoL); Supportive care; Treatment-associated problems