Researchers found patients assigned significantly higher value to palliative care services supporting physical functioning and pain management
The joint study between King's College London, Monash University Malaysia and Hospis Malaysia has delved into the intricate interplay between the quality of life (QoL) and survival preferences of advanced cancer patients by quantifying patients' preferences for QoL outcomes against survival.
Published in Value in Health, the research focuses on palliative care access in Malaysia. Palliative care is a medical approach that aims to improve quality of life by preventing and relieving suffering, as well as treating a patient's pain and any other problems they face.
Following an analysis conducted by PhD student Alene Yong during a research placement at King's, results revealed that advanced cancer patients assigned significantly higher value to QoL improvements than to one-year survival.
However, life extension only brings value to them when they can maintain at least moderate levels of functioning. Patients considered the importance of physical functioning and having good pain control a priority, with follow-up sessions conducted three months later showing an increased importance on these priorities.
Patients were also invited to participate in interviews to gain deeper insights into their experiences and the impact of care accessibility on their preferences. Many patients recounted enduring debilitating side effects of treatments, which they described as "destroying the remaining days" of their lives.
Alongside physical impairments and reduced ability to work, younger patients expressed emotional distress when they could not fulfil their household responsibilities, including housekeeping and caring for children.
Together, these results suggest that more resources and attention must be given to strengthening supportive and palliative care services in cancer care while ensuring access to novel technologies for life-extending treatments.
Limited access to palliative care services contribute to suffering experienced by cancer patients, particularly in low and middle-income countries (LMICs). Globally, only 14% of hospice and palliative care needs are met, with most unmet needs concentrated in LMICs. Within the Malaysian health system, over 63% of cancer patients were diagnosed in advanced stages, yet access to palliative care was available to less than 10% of the population.
These findings underscore not just the importance of providing palliative and supportive care for patients with advanced cancer to alleviate issues on physical functioning and pain, but also regularly involving patients in decisions about management of their advanced cancer.
Ka Keat Lim, Research Fellow in Health Economics, School of Life Course & Population Sciences
