Patient Satisfaction and Quality of Life Before and After Treatment of Pancreatic and Periampullary Cancer: A Prospective Multicenter Study

Restricted access

Background: This study sought to assess patient satisfaction and quality of life (QoL) before and after treatment of pancreatic and periampullary cancer. Methods: We conducted a prospective multicenter study of patients treated for pancreatic and periampullary cancer. General patient satisfaction was measured using the EORTC satisfaction with care questionnaire (IN-PATSAT32) at baseline and 3 months after treatment initiation, with a 10-point change on the Likert scale considered clinically meaningful. QoL was measured using the EORTC Core Quality of Life Questionnaire (QLQ-C30). The influence of treatment (curative and palliative) on patient satisfaction and QoL was determined. Results: Of 100 patients, 71 completed follow-up questionnaires. General satisfaction with care decreased from 74.3 before treatment to 61.9 after treatment (P<.001), whereas global QoL increased from 68.4 to 71.4 (P=.39). Clinically meaningful reductions were also observed for the reported interpersonal skills of doctors (from 73.4 to 63.3) and exchange of information within the care team (from 63.5 to 52.5). Satisfaction scores were lower for patients treated with curative intent than for those treated with palliative intent regarding interpersonal skills of doctors (P=.01), information provision by doctors (P=.004), information provision by nurses (P=.02), availability of nurses (P=.004), exchange of information within the care team (P=.01), and hospital access (P=.02). In multivariable analysis, clinicopathologic or QoL factors were not independently associated with general patient satisfaction. Conclusions: Satisfaction with care, but not QoL, decreased after pancreatic cancer treatment. Improvements in communication and interpersonal skills are needed to maintain patient satisfaction after treatment.

Submitted October 10, 2019; accepted for publication January 2, 2020.

Author contributions: Study concept and design: Mackay, van Rijssen, Andriessen, Besselink, Van Laarhoven. Data acquisition and analysis: Mackay, van Rijssen, Andriessen, Besselink, Van Laarhoven. Data interpretation: All authors. Manuscript preparation: All authors. Critical revision: All authors.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Funding: This study was partially supported by a grant from the Dutch Cancer Society (grant UVA2013-5842; H.W.V.L.).

Correspondence: Hanneke W. van Laarhoven, MD, PhD, Department of Medical Oncology, D3-312, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. Email: h.vanlaarhoven@amsterdamumc.nl

Supplementary Materials

    • Supplemental Materials (PDF 465.86 KB)
  • 1.

    Brédart A, Beaudeau A, Young T, . The European Organization for Research and Treatment of Cancer - satisfaction with cancer care questionnaire: revision and extended application development. Psychooncology 2017;26:400404.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Kleefstra SM, Zandbelt LC, de Haes HJ, . Trends in patient satisfaction in Dutch university medical centers: room for improvement for all. BMC Health Serv Res 2015;15:112.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Barr JK, Giannotti TE, Sofaer S, . Using public reports of patient satisfaction for hospital quality improvement. Health Serv Res 2006;41:663682.

  • 4.

    Riiskjær E, Ammentorp J, Nielsen JF, . Patient surveys—a key to organizational change? Patient Educ Couns 2010;78:394401.

  • 5.

    Aiken LH, Sermeus W, Van den Heede K, . Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012;344:e1717.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Liu Y, Malin JL, Diamant AL, . Adherence to adjuvant hormone therapy in low-income women with breast cancer: the role of provider-patient communication. Breast Cancer Res Treat 2013;137:829836.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Gupta D, Rodeghier M, Lis CG. Patient satisfaction with service quality in an oncology setting: implications for prognosis in non-small cell lung cancer. Int J Qual Health Care 2013;25:696703.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Kleeberg UR, Feyer P, Günther W, . Patient satisfaction in outpatient cancer care: a prospective survey using the PASQOC questionnaire. Support Care Cancer 2008;16:947954.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Williams B, Coyle J, Healy D. The meaning of patient satisfaction: an explanation of high reported levels. Soc Sci Med 1998;47:13511359.

  • 10.

    Conroy T, Desseigne F, Ychou M, . FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med 2011;364:18171825.

  • 11.

    Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg 2015;220:530536.

  • 12.

    Carrato A, Falcone A, Ducreux M, . A systematic review of the burden of pancreatic cancer in Europe: real-world impact on survival, quality of life and costs. J Gastrointest Cancer 2015;46:201211.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Suker M, Beumer BR, Sadot E, . FOLFIRINOX for locally advanced pancreatic cancer: a systematic review and patient-level meta-analysis. Lancet Oncol 2016;17:801810.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Von Hoff DD, Ervin T, Arena FP, . Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 2013;369:16911703.

  • 15.

    McPhee JT, Hill JS, Whalen GF, . Perioperative mortality for pancreatectomy: a national perspective. Ann Surg 2007;246:246253.

  • 16.

    Kotronoulas G, Kearney N, Maguire R, . What is the value of the routine use of patient-reported outcome measures toward improvement of patient outcomes, processes of care, and health service outcomes in cancer care? A systematic review of controlled trials. J Clin Oncol 2014;32:14801501.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Lis CG, Rodeghier M, Grutsch JF, . Distribution and determinants of patient satisfaction in oncology with a focus on health related quality of life. BMC Health Serv Res 2009;9:190.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Bleich SN, Ozaltin E, Murray CK. How does satisfaction with the health-care system relate to patient experience? Bull World Health Organ 2009;87:271278.

  • 19.

    Coebergh van den Braak RRJ, van Rijssen LB, van Kleef JJ, . Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative. Acta Oncol 2018;57:195202.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    van de Poll-Franse LV, Horevoorts N, van Eenbergen M, . The Patient Reported Outcomes Following Initial treatment and Long term Evaluation of Survivorship registry: scope, rationale and design of an infrastructure for the study of physical and psychosocial outcomes in cancer survivorship cohorts. Eur J Cancer 2011;47:21882194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Brédart A, Bottomley A, Blazeby JM, . An international prospective study of the EORTC cancer in-patient satisfaction with care measure (EORTC IN-PATSAT32). Eur J Cancer 2005;41:21202131.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Aaronson NK, Ahmedzai S, Bergman B, . The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365376.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Osoba D, Rodrigues G, Myles J, . Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 1998;16:139144.

  • 24.

    Lis CG, Rodeghier M, Gupta D. Distribution and determinants of patient satisfaction in oncology: a review of the literature. Patient Prefer Adherence 2009;3:287304.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Avery KN, Metcalfe C, Nicklin J, . Satisfaction with care: an independent outcome measure in surgical oncology. Ann Surg Oncol 2006;13:817822.

  • 26.

    Batbaatar E, Dorjdagva J, Luvsannyam A, . Determinants of patient satisfaction: a systematic review. Perspect Public Health 2017;137:89101.

  • 27.

    Gupta D, Markman M, Rodeghier M, . The relationship between patient satisfaction with service quality and survival in pancreatic cancer. Patient Prefer Adherence 2012;6:765772.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Kleeberg UR, Tews JT, Ruprecht T, . Patient satisfaction and quality of life in cancer outpatients: results of the PASQOC study. Support Care Cancer 2005;13:303310.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Ong LM, Visser MR, Lammes FB, . Doctor–patient communication and cancer patients’ quality of life and satisfaction. Patient Educ Couns 2000;41:145156.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Vashisht A, Domoney CL, Handscomb K, . Patient satisfaction with the care provided at a gynaecology oncology clinic. J Obstet Gynaecol 2000;20:183184.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Thomas S, Glynne-Jones R, Chait I. Is it worth the wait? A survey of patients’ satisfaction with an oncology outpatient clinic. Eur J Cancer Care (Engl) 1997;6:5058.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Bergenmar M, Nylén U, Lidbrink E, . Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol 2006;45:550558.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Brédart A, Razavi D, Robertson C, . Assessment of quality of care in an oncology institute using information on patients’ satisfaction. Oncology 2001;61:120128.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    McNamara S, Brown J. An audit of patient satisfaction with a neuro-oncology clinic. Eur J Oncol Nurs 2003;7:200203.

  • 35.

    Wiggers JH, Donovan KO, Redman S, . Cancer patient satisfaction with care. Cancer 1990;66:610616.

  • 36.

    Brown RF, Hill C, Burant CJ, . Satisfaction of early breast cancer patients with discussions during initial oncology consultations with a medical oncologist. Psychooncology 2009;18:4249.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Eide H, Graugaard P, Holgersen K, . Physician communication in different phases of a consultation at an oncology outpatient clinic related to patient satisfaction. Patient Educ Couns 2003;51:259266.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Coulter A, Entwistle V, Gilbert D. Sharing decisions with patients: is the information good enough? BMJ 1999;318:318322.

  • 39.

    Di Cristofaro L, Ruffolo C, Pinto E, . Complications after surgery for colorectal cancer affect quality of life and surgeon-patient relationship. Colorectal Dis 2014;16:O407419.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    van Rijssen LB, van der Geest LG, Bollen TL, . National compliance to an evidence-based multidisciplinary guideline on pancreatic and periampullary carcinoma. Pancreatology 2016;16:133137.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Basta YL, Baur OL, van Dieren S, . Is there a benefit of multidisciplinary cancer team meetings for patients with gastrointestinal malignancies? Ann Surg Oncol 2016;23:24302437.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Burnet K, Chapman D, Wishart G, . Nurse specialists in breast care: a developing role. Nurs Stand 2004;18:3842.

  • 43.

    Haward R, Amir Z, Borrill C, . Breast cancer teams: the impact of constitution, new cancer workload, and methods of operation on their effectiveness. Br J Cancer 2003;89:1522.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Walker MS, Ristvedt SL, Haughey BH. Patient care in multidisciplinary cancer clinics: does attention to psychosocial needs predict patient satisfaction? Psychooncology 2003;12:291300.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Pompili C, Tiberi M, Salati M, . Patient satisfaction with health-care professionals and structure is not affected by longer hospital stay and complications after lung resection: a case-matched analysis. Interact Cardiovasc Thorac Surg 2015;20:236241.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Heerkens HD, Tseng DS, Lips IM, . Health-related quality of life after pancreatic resection for malignancy. Br J Surg 2016;103:257266.

  • 47.

    Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, . Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol 2013;31:2329.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 409 409 327
PDF Downloads 128 128 102
EPUB Downloads 0 0 0