Jennifer Gabbard, Saadia Nur, Beverly J Levine, Thomas W Lycan, Nicholas Pajewski, Erica Frechman, Kathryn E Callahan, Heidi Klepin, Laurie E McLouth
{"title":"电子健康记录 (EHR) 嵌入式虚弱指数与接受免疫疗法的转移性非小细胞肺癌患者的患者报告结果之间的关联:简要报告。","authors":"Jennifer Gabbard, Saadia Nur, Beverly J Levine, Thomas W Lycan, Nicholas Pajewski, Erica Frechman, Kathryn E Callahan, Heidi Klepin, Laurie E McLouth","doi":"10.1177/10499091231223964","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background</i></b>: While frailty is a well-established predictor of overall mortality among patients with metastatic non-small cell lung cancer (mNSCLC), its association with patient-reported outcomes is not well-characterized. The goal of this study was to examine the association between an electronic frailty index (eFI) score and patient-reported outcome measures along with prognostic awareness among patients with mNSCLC receiving immunotherapy. <b><i>Methods</i></b>: In a cross-sectional study, patients with mNSCLC who were on immunotherapy completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the National Cancer Institute Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). We utilized bivariate analyses to compare quality of life, symptoms, supportive services, and prognostic awareness among 3 groups defined by e-frailty status. <b><i>Results</i></b>: Sixty patients (mean age 62.5 years, 75% Caucasian, 60% women) participated. Most patients were pre-frail (68%), with 13% being frail and 18% non-frail. Pre-frail and frail patients had significantly lower physical function scores (mean 83.9 fit vs 74.8 pre-frail vs 60.0 frail, <i>P</i> = .04) and higher rates of self-reported pain (75% frail vs 41.5% pre-frail vs 18.2% fit; <i>P</i> = .04) compared to non-frail patients. We found no differences in palliative referral rates. <b><i>Conclusion</i></b>: Pre-frail and frail mNSCLC patients identified by the eFI have higher rates of pain and physical functional impairments than non-frail patients. These findings highlight the importance of emphasizing preventive interventions targeting social needs, functional limitations, and pain management, especially among pre-frail patients to reduce further decline.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192858/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Association Between an Electronic Health Record (EHR)-Embedded Frailty Index and Patient-Reported Outcomes Among Patients with Metastatic Non-Small-Cell Lung Cancer on Immunotherapy: A Brief Report.\",\"authors\":\"Jennifer Gabbard, Saadia Nur, Beverly J Levine, Thomas W Lycan, Nicholas Pajewski, Erica Frechman, Kathryn E Callahan, Heidi Klepin, Laurie E McLouth\",\"doi\":\"10.1177/10499091231223964\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background</i></b>: While frailty is a well-established predictor of overall mortality among patients with metastatic non-small cell lung cancer (mNSCLC), its association with patient-reported outcomes is not well-characterized. The goal of this study was to examine the association between an electronic frailty index (eFI) score and patient-reported outcome measures along with prognostic awareness among patients with mNSCLC receiving immunotherapy. <b><i>Methods</i></b>: In a cross-sectional study, patients with mNSCLC who were on immunotherapy completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the National Cancer Institute Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). We utilized bivariate analyses to compare quality of life, symptoms, supportive services, and prognostic awareness among 3 groups defined by e-frailty status. <b><i>Results</i></b>: Sixty patients (mean age 62.5 years, 75% Caucasian, 60% women) participated. Most patients were pre-frail (68%), with 13% being frail and 18% non-frail. Pre-frail and frail patients had significantly lower physical function scores (mean 83.9 fit vs 74.8 pre-frail vs 60.0 frail, <i>P</i> = .04) and higher rates of self-reported pain (75% frail vs 41.5% pre-frail vs 18.2% fit; <i>P</i> = .04) compared to non-frail patients. We found no differences in palliative referral rates. <b><i>Conclusion</i></b>: Pre-frail and frail mNSCLC patients identified by the eFI have higher rates of pain and physical functional impairments than non-frail patients. These findings highlight the importance of emphasizing preventive interventions targeting social needs, functional limitations, and pain management, especially among pre-frail patients to reduce further decline.</p>\",\"PeriodicalId\":94222,\"journal\":{\"name\":\"The American journal of hospice & palliative care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192858/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The American journal of hospice & palliative care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/10499091231223964\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/12/22 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American journal of hospice & palliative care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/10499091231223964","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/22 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:虽然虚弱是预测转移性非小细胞肺癌(mNSCLC)患者总死亡率的一个公认指标,但它与患者报告的预后结果之间的关系还没有得到很好的描述。本研究的目的是探讨电子虚弱指数(eFI)评分与患者报告的预后指标之间的关系,以及接受免疫疗法的 mNSCLC 患者对预后的认识。研究方法在一项横断面研究中,接受免疫疗法的 mNSCLC 患者填写了欧洲癌症研究和治疗组织生活质量问卷核心 30 (EORTC-QLQ-C30) 和美国国家癌症研究所不良事件通用术语标准患者报告结果版本 (PRO-CTCAE)。我们利用双变量分析比较了根据电子虚弱状态定义的 3 个群体的生活质量、症状、支持服务和预后意识。结果60 名患者(平均年龄 62.5 岁,75% 为白种人,60% 为女性)参与了研究。大多数患者为虚弱前期(68%),13%为虚弱期,18%为非虚弱期。与非体弱患者相比,体弱前期和体弱患者的身体功能评分明显较低(平均 83.9 分体弱 vs 74.8 分体弱前期 vs 60.0 分体弱,P = .04),自述疼痛率较高(75% 体弱 vs 41.5% 体弱前期 vs 18.2% 体弱;P = .04)。我们发现姑息治疗转诊率没有差异。结论:与非体弱患者相比,eFI 确定的体弱前期和体弱 mNSCLC 患者的疼痛和身体功能障碍发生率更高。这些发现强调了针对社会需求、功能限制和疼痛管理的预防性干预措施的重要性,尤其是对前期虚弱患者,以减少病情的进一步恶化。
The Association Between an Electronic Health Record (EHR)-Embedded Frailty Index and Patient-Reported Outcomes Among Patients with Metastatic Non-Small-Cell Lung Cancer on Immunotherapy: A Brief Report.
Background: While frailty is a well-established predictor of overall mortality among patients with metastatic non-small cell lung cancer (mNSCLC), its association with patient-reported outcomes is not well-characterized. The goal of this study was to examine the association between an electronic frailty index (eFI) score and patient-reported outcome measures along with prognostic awareness among patients with mNSCLC receiving immunotherapy. Methods: In a cross-sectional study, patients with mNSCLC who were on immunotherapy completed the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) and the National Cancer Institute Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). We utilized bivariate analyses to compare quality of life, symptoms, supportive services, and prognostic awareness among 3 groups defined by e-frailty status. Results: Sixty patients (mean age 62.5 years, 75% Caucasian, 60% women) participated. Most patients were pre-frail (68%), with 13% being frail and 18% non-frail. Pre-frail and frail patients had significantly lower physical function scores (mean 83.9 fit vs 74.8 pre-frail vs 60.0 frail, P = .04) and higher rates of self-reported pain (75% frail vs 41.5% pre-frail vs 18.2% fit; P = .04) compared to non-frail patients. We found no differences in palliative referral rates. Conclusion: Pre-frail and frail mNSCLC patients identified by the eFI have higher rates of pain and physical functional impairments than non-frail patients. These findings highlight the importance of emphasizing preventive interventions targeting social needs, functional limitations, and pain management, especially among pre-frail patients to reduce further decline.