Health Related Quality of Life : Tailored Internet Support for Cancer Patients

Abstract

Background Cancer places a considerable burden on patients’ health-related quality of life (HRQOL). Information on own disease can both help patients to cope with symptoms and side-effects, and make them more competent participants in shared decision-making with clinicians. In this context the Center for Shared Decision Making and Nursing Research developed a tailored Internet support system called WebChoice. This thesis is a partial economic evaluation of the effects of WebChoice, where its impact on HRQOL is explored.

Methods The research team randomised breast cancer and prostate cancer patients into two groups, a WebChoice group and a control group. The patients’ HRQOL was measured three times during the intervention period of one year. HRQOL weights were measured with the multi attribute health status classification system, 15D. This thesis measures the health outcome and WebChoice effects by statistical methods. The health outcome was measured in quality adjusted life years (QALYs). Data were analysed with t-tests and multiple linear regressions.

Results In total, 445 patients were recruited and randomised to WebChoice groups or control groups. This thesis presents data for 234 patients who filled in the 15D questionnaire at baseline, at 6 months and at 12 months. Among 130 breast cancer patients included in this study, the mean 15D score at baseline was 0.85 in the WebChoice group and 0.88 in the control group, while the respective means were 0.85 and 0.88 by the end of the trial. Among 104 prostate cancer patients included in this study, the mean 15D score at baseline was 0.87 in the WebChoice group and 0.87 in the control group, while the respective means were 0.84 and 0.84 by the end of the trial. Adjusted for baseline 15D, the mean QALYs gained for WebChoice compared to the control group, was -0.03 for the breast cancer group and -0.01 for the prostate cancer group. HRQOL score at baseline was the only variable which had a significant impact on this result. Interpretation/conclusion

The results of this study indicate that WebChoice has no impact on HRQOL for breast cancer and prostate cancer patients. However, the conclusion must be made with the following reservations: The result does not necessarily apply to patients with a recent diagnosis, or with little education or with a low HRQOL.