Evaluation of inpatient cancer rehabilitation by routine electronic patient-reported outcome measures (ePROM): Improvement of quality of life (QoL) and psychological distress.

Abstract

e18294 Background: Many cancer survivors suffer from psychological distress and poor QoL. Cancer rehabilitation is aimed at improving their condition but the benefit remains controversial, we have thus investigated the outcome. Methods: ePROM were routinely integrated into the inpatient program of a cancer rehabilitation center in Austria. Hospital Anxiety and Depression Scale (HADS) was used to assess distress, and EORTC QLQ-C30 questionnaire for analysis of cancer-related symptoms and functions. Patients answered questions via internet prior to admission (T0). This allowed for allocation of physical therapies and 4-8 psychological counseling sessions according to their needs. Following informed consent, the outcome was investigated likewise by the time of discharge after 3 weeks (T1). Data were analyzed with SPSS software using ANOVA repeated measures. Results: 4198 patients (age 59.2±11.7 yr; range 18-91 years; 61.5% female) participated between January 2015, and August 2018. HADS identified a marked reduction of anxiety and depression, with distress levels similar to the normal population by T1. QLQ-C30 revealed significant increases for global QoL; physical, social, emotional and role functions. All recorded symptoms were improved, in particular fatigue, pain and insomnia. Moreover, subgroup analyses confirmed improvement for 11 investigated entities. Of notice, decrease of anxiety was most prominent in survivors of breast, head/neck and lung cancer patients (p < 0.001). No significant differences were observed between a subgroup of 1122 elderly ( > 70 yr), and younger patients except for the physical function, which improved significantly in older patients (p = 0.003). Conclusions: Our study shows that inclusion of ePROM into inpatient cancer rehabilitation helps allocate therapies according to individual needs. This large series demonstrates significant reduction of psychological distress and improvement of all parameters of QoL. [Table: see text]