Qolp-07. A Pilot Study to Assess the Integration of a Unique Proqol Tool and Early Palliative Care Intervention in the Care of High Grade Glioma Patients and Their Caregivers

Abstract

BACKGROUND Early involvement of palliative care (PC) in patients with metastatic cancer has been associated with improved quality of life (QOL). Patients with high grade glioma (pwHGG) and their caregivers have unique needs such that similar results are anticipated in this population but cannot be extrapolated. Recognizing that pwHGG often require a caregiver early in the course of disease, this patient population also experiences significant personal and caregiver distress that has been given limited attention and resources. AIM: To assess the feasibility of implementation of a novel patient reported outcomes (PRO) quality of life (QOL) tool administered by smart device in routine office visit (OV) and early integration of palliative care (PC) for pwHGG and their caregivers to improve QOL for both. DESIGN: Prospective, single-center cluster-randomized pilot conducted for 6 months during completion of adjuvant therapy for newly diagnosed high grade glioma. After informed consent was obtained, 15 pwHGG and their caregivers were randomized to: routine OV with basic QOL survey; OV with PROQOL; or PC consultation, in addition to OV with PROQOL. RESULTS Two elderly patients with declining performance status transitioned to hospice after initial visit, and one moved out of state prior to adjuvant visits. Thus far 5/15 patients/caregivers have successfully completed the pilot with the 6 remaining participants due to complete in November 2019. DISCUSSION The PROQOL appears to be easily integrated into OV without significant patient, caregiver, or provider burden. Providers confirmed utility in prioritizing symptoms and concerns. Thus far, it appears that patients (and caregivers) appeared to benefit from the PROQOL and PC support as evidenced by longitudinal improvement in QOL scores over the control group. CONCLUSIONS A unique PROQOL tool and early PC can be easily integrated into practice, and may improve the QOL of pwHGG and their caregivers.

Palliative Care in High-Grade Glioma: A Review

“…There is currently no strong evidence base or expert consensus on the ideal model for integrating palliative care into neuro-oncology, which remains the subject of active research [ 73 , 74 ]. Existing models for outpatient palliative care include oncologists providing primary palliative care without specialty input; oncologists referring to specialty palliative care based on clinical judgment, and integrated models with oncologists and palliative care specialists working as a coordinated team, perhaps co-located in a single multidisciplinary clinic [ 75 , 76 ].…”