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Quality of Life and Utility in Patients with Non-Small Cell Lung Cancer

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Abstract

Background: Although several studies have determined quality of life in patients with lung cancer, there is still little information about the use of generic questionnaires [e.g. the 36-item Short Form health survey (SF-36)] and utility questionnaires [e.g. the EuroQOL instrument (EQ-5D)] in this disease.

Objectives: To (i) measure quality of life and utility in patients with non-small cell lung cancer (NSCLC) using the SF-36 and the EuroQOL questionnaires; (ii) to evaluate the impact of some clinical variables on quality of life and utility; (iii) to assess the correlation between the measurements produced by the 2 questionnaires.

Study design: Cross-sectional study.

Participants: 95 patients from15 Italian hospitals with NSCLC (93% male, mean age 62 years) completed both questionnaires.

Results: The mean scores for the 8 domains of the SF-36 ranged from 20.8 (physical role) to 63.0 (social functioning). The mean physical and mental summed scores of the SF-36 were 36.8 [standard deviation (SD) 9.8] and 43.0 (SD 11.5), respectively. The EuroQOL mean score was 0.58 (SD 0.32) in the self-classifier (SC) version and 0.58 (SD 0.20) in the visual analogue scale (VAS) version. Among the clinical variables that affected quality of life and utility, the presence of metastasis had the greatest impact: patients with metastasis had statistically significantly lower scores for 2 domains of the SF-36 (physical functioning, p = 0.009; bodily pain, p = 0.016), for the physical component summed score of the SF-36 (p = 0.015) and for both utility estimates (EuroQOL-SC, p = 0.027; EuroQOL-VAS, p = 0.038) than patients without metastasis. Both the SC and VAS EuroQOL scores showed a statistically significant correlation with each of the 8 domains of the SF-36. The scores for both the SF-36 and the EuroQOL in patients with NSCLC were considerably worse (relative differences ranging from −8 to −73%) than the corresponding values (normative data) previously reported for healthy individuals.

Conclusions: Our study quantified the degree to which quality of life is impaired in patients with NSCLC, showed that the presence of metastasis had an important role, and indicated a strong correlation between the measurements produced by the 2 questionnaires. The EuroQOL measurements obtained from these patients will aid evaluation of the cost-utility ratio for NSCLC therapies.

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Acknowledgements

Four educational meetings for the hospital pharmacists involved in the project were funded in part by Eli-Lilly, Spa, Italy.

The list of study participants includes the study coordinators (Trippoli S, Vaiani M, Messori A, Società Italiana di Farmacia Ospedaliera; Lucioni C, Istituto di Economia Sanitaria, Milano), the 19 participants at the Seminar ‘Master 2 in Farmacoeconomia’ (Firenze, 11-12 May 1999, 15-16 June 1999 and 21-22 September 1999; Roma, 15 December 1999) and the clinicians who were responsible for patient recruitment and quality-of-life interviews. The names and addresses (all towns/cities in Italy) of seminar participants and clinicians involved in the project were the following: Basadonna O, Rampazzo R, Gaion F, Morabito A, Sorarù M (Camposampiero, Padova); Becagli P, Panella M (Prato); Bianco MT, Marsili S (Siena); Burlon N, Medici M, Paccagnella A (Mestre, Venezia); Cannas A, Massidda B (Cagliari); Costantini M, Di Turi R, Cipri A, De Marinis F, Portalone L (Roma); Forresu MC, Staico G, Ortu S (Olbia, Sassari); Guido MA, Meo AT, Squillacioti A, Anania AM, Bagnato S, Prantera T (Crotone); Millevoi G, Iop A (Palmanova, Udine); Pistolesi C, Santo A, Bassetto A, Cetto, GL, Durante E (Verona); Rinaldi M, Pennucci C, Spinelli I (Carrara); Scanavacca P, Ballerin L, Indelli M (Ferrara); Sovernigo G, Bianco A (Conegliano Veneto, Treviso); Spoldi L, Arnoldi E, Comelli A (Seriate, Bergamo); Lopes Pegna A (Firenze).

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Correspondence to Andrea Messori.

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Trippoli, S., Vaiani, M., Lucioni, C. et al. Quality of Life and Utility in Patients with Non-Small Cell Lung Cancer. Pharmacoeconomics 19, 855–863 (2001). https://doi.org/10.2165/00019053-200119080-00007

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