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Outcome prioritization and preferences among older adults with cancer starting chemotherapy in a randomized clinical trial.
- Source :
-
Cancer [Cancer] 2024 Sep 01; Vol. 130 (17), pp. 3000-3010. Date of Electronic Publication: 2024 Apr 17. - Publication Year :
- 2024
-
Abstract
- Introduction: Older adults with cancer facing competing treatments must prioritize between various outcomes. This study assessed health outcome prioritization among older adults with cancer starting chemotherapy.<br />Methods: Secondary analysis of a randomized trial addressing vulnerabilities in older adults with cancer. Patients completed three validated outcome prioritization tools: 1) Health Outcomes Tool: prioritizes outcomes (survival, independence, symptoms) using a visual analog scale; 2) Now vs. Later Tool: rates the importance of quality of life at three times-today versus 1 or 5 years in the future; and 3) Attitude Scale: rates agreement with outcome-related statements. The authors measured the proportion of patients prioritizing various outcomes and evaluated their characteristics.<br />Results: A total of 219 patients (median [range] age 71 [65-88], 68% with metastatic disease) were included. On the Health Outcomes Tool, 60.7% prioritized survival over other outcomes. Having localized disease was associated with choosing survival as top priority. On the Now vs. Later Tool, 50% gave equal importance to current versus future quality of life. On the Attitude Scale, 53.4% disagreed with the statement "the most important thing to me is living as long as I can, no matter what my quality of life is"; and 82.2% agreed with the statement "it is more important to me to maintain my thinking ability than to live as long as possible".<br />Conclusion: Although survival was the top priority for most participants, some older individuals with cancer prioritize other outcomes, such as cognition and function. Clinicians should elicit patient-defined priorities and include them in decision-making.<br /> (© 2024 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)
Details
- Language :
- English
- ISSN :
- 1097-0142
- Volume :
- 130
- Issue :
- 17
- Database :
- MEDLINE
- Journal :
- Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 38630903
- Full Text :
- https://doi.org/10.1002/cncr.35333