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Patient-reported outcome measures (PROMs) show worse physical function, increased fatigue, and higher pain interference in cancer patients nearing death. Routinely collected PROMs can indicate the terminal stage for earlier supportive care interventions.

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Area of Science:

  • Oncology
  • Health Outcomes Research
  • Palliative Care

Background:

  • Patient-reported outcome measures (PROMs) offer valuable insights into patient experiences, complementing clinical assessments.
  • Understanding real-time changes in PROMs near the end of life is crucial for timely interventions.
  • Limited data exists on PROM score trajectories in the final months of life for cancer patients.

Purpose of the Study:

  • To evaluate differences in mean PROM scores between cancer patients within 6 months of death and surviving cancer patients.
  • To identify specific PROM domains that change significantly as the end of life approaches in cancer patients.

Main Methods:

  • Retrospective case-control study utilizing National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS) instruments.
  • Cases: cancer patients who died within 6 months of PROM completion. Controls: matched surviving cancer patients (1:3 ratio).
  • Generalized estimating equation models assessed differences in mean PROM scores for pain interference, physical function, fatigue, and depression.

Main Results:

  • Significant differences in mean PROM scores were observed between cases and controls after adjustments.
  • Physical function showed the largest decline in cases (mean score 6.52 points lower).
  • Cases reported increased fatigue (4.83 points higher) and pain interference (4.33 points higher) compared to controls.

Conclusions:

  • Cancer patients within 6 months of death exhibit significantly worse PROM scores across physical function, fatigue, pain interference, and depression domains.
  • Routinely collected PROMs can serve as a real-time indicator of the terminal phase of life in cancer patients.
  • These findings support the use of PROMs for earlier identification of patients needing enhanced supportive oncology services.