Article

Assessment of Neutropenia-Related Quality of Life in a Clinical Setting

Mary E. Ropka

Geraldine Padilla

Assessment, neutropenia
ONF 2007, 34(2), 403-409. DOI: 10.1188/07.ONF.403-409

Purpose/Objectives: To examine how neutropenia affects quality of life (QOL) and explore strategies to assess neutropenia-related QOL in clinical practice.

Data Sources: Published articles, abstracts, conference proceedings, and clinical practice guidelines.

Data Synthesis: Neutropenia can have a detrimental effect on the QOL of patients receiving chemotherapy. A neutropenia-related QOL questionnaire can help nurses better identify patients at risk for developing neutropenia and monitor patients who already have it. In some cases, the questionnaire may be the first step in the initiation of interventions to improve patient care. Ideally, the QOL questionnaire should be easy to use, provide clinically meaningful information, and be easily adapted from existing QOL measurement tools.

Conclusions: Effective implementation of QOL assessments into clinical practice can lead to the initiation of interventions that may improve neutropenia-related QOL in patients with cancer receiving chemotherapy.

Implications for Nursing: Nurses can enhance their clinical judgment and affect patient treatment by implementing a questionnaire that assesses patients' neutropenia-related QOL.

Jump to a section

    References

    Aaronson, N.K. (1998). Assessing the quality of life of patients with cancer: East meets west. European Journal of Cancer, 34, 767-769.
    American Society of Clinical Oncology. (1996). Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. Journal of Clinical Oncology, 14, 671-679.
    Ballatori, E. (2001). Unsolved problems in evaluating the quality of life of cancer patients. Annals of Oncology, 12(Suppl. 3), S11-S13.
    Bedell, C. (2003). Pegfilgrastim for chemotherapy-induced neutropenia. Clinical Journal of Oncology Nursing, 7, 55-56.
    Berry, D.L., Trigg, L.J., Lober, W.B., Karras, B.T., Galligan, M.L., Austin-Seymour, M., et al. (2004). Computerized symptom and quality-of-life assessment for patients with cancer part I: Development and pilot testing [Online exclusive]. Oncology Nursing Forum, 31, E75-E83. Retrieved January 26, 2007, from http://www.ons.org/publications/journals/ONF/Volume31/Issue5/3105895.asp
    Bjelland, I., Dahl, A.A., Haug, T.T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52, 69-77.
    Bonadonna, G., Moliterni, A., Zambetti, M., Daidone, M.G., Pilotti, S., Gianni, L., et al. (2005). 30 years' follow up of randomised studies of adjuvant CMF in operable breast cancer: Cohort study [Epub]. BMJ, 330, 217.
    Buchanan, D.R., O'Mara, A.M., Kelaghan, J.W., & Minasian, L.M. (2005). Quality-of-life assessment in the symptom management trials of the National Cancer Institute-supported Community Clinical Oncology Program. Journal of Clinical Oncology, 23, 591-598.
    Calhoun, E.A., Chang, C.H., Welshman, E., & Cella, D. (2002, May). A neutropenia-specific quality of life instrument: Rationale for the development of the FACT-N [Abstract 1498]. Poster presented at the annual meeting of the American Society of Clinical Oncology, Orlando, FL.
    Calhoun, E.A., Chang, C.H., Welshman, E., & Cella, D. (2003). The impact of chemotherapy delays on quality of life in patients with cancer [Abstract 2220]. Proceedings of the American Society of Clinical Oncology, 22, 552.
    Cancer Therapy Evaluation Program. (2003). Common terminology criteria for adverse events, version 3.0 (CTCAE). Retrieved July 28, 2006, from http://ctep.cancer.gov/forms/CTCAEv3.pdf
    Cella, D., Chang, C.H., Lai, J.S., & Webster, K. (2002). Advances in quality of life measurements in oncology patients. Seminars in Oncology, 29(3, Suppl. 8), 60-68.
    Cella, D., Hernandez, L., Bonomi, A.E., Corona, M., Vaquero, M., Shiomoto, G., et al. (1998). Spanish language translation and initial validation of the Functional Assessment of Cancer Therapy quality-of-life instrument. Medical Care, 36, 1407-1418.
    Cella, D.F., Tulsky, D.S., Gray, G., Sarafian, B., Linn, E., Bonomi, A., et al. (1993). The Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570-579.
    Chang, V.T., Hwang, S.S., Kasimis, B., & Thaler, H.T. (2004). Shorter symptom assessment instruments: The Condensed Memorial Symptom Assessment Scale (CMSAS). Cancer Investigation, 22, 526-536.
    Cheung, Y.B., Goh, C., Wong, L.C., Ng, G.Y., Lim, W.T., Leong, S.S., et al. (2004). Quick-FLIC: Validation of a short questionnaire for assessing quality of life of cancer patients. British Journal of Cancer, 90, 1747-1752.
    Crawford, J. (2004). The importance of chemotherapy dose intensity in lung cancer. Seminars in Oncology, 31(6, Suppl. 15), 25-31.
    Crighton, M.H. (2004). Dimensions of neutropenia in adult cancer patients: Expanding conceptualizations beyond the numerical value of the absolute neutrophil count. Cancer Nursing, 27, 275-284.
    Dancey, J., Zee, B., Osoba, D., Whitehead, M., Lu, F., Kaizer, L., et al. (1997). Quality of life scores: An independent prognostic variable in a general population of cancer patients receiving chemotherapy. National Cancer Institute of Canada Clinical Trials Group. Quality of Life Research, 6, 151-158.
    Daniel, D., & Crawford, J. (2006). Myelotoxicity from chemotherapy. Seminars in Oncology, 33, 74-85.
    Dunckley, M., Hughes, R., Addington-Hall, J.M., & Higginson, I.J. (2003). Translating clinical tools in nursing practice. Journal of Advanced Nursing, 44, 420-426.
    Epelbaum, R., Haim, N., Ben-Shahar, M., Ron, Y., & Cohen, Y. (1988). Dose intensity for CHOP chemotherapy in diffuse aggressive large cell lymphoma. Israel Journal of Medical Sciences, 24, 533-538.
    Fortner, B., Okon, T., Schwartzberg, L., Tauer, K., & Houts, A.C. (2003). The Cancer Care Monitor: Psychometric content evaluation and pilot testing of a computer administered system for symptom screening and quality of life in adult cancer patients. Journal of Pain and Symptom Management, 26, 1077-1092.
    Fortner, B.V., Stolshek, B.S., Tauer, K.W., Okon, T.A., Durrence, H., White, J., et al. (2002). Final analysis: Chemotherapy induced neutropenia (CIN) is associated with lower quality of life (QoL) in patients (pts) with cancer [Abstract 640P]. Annals of Oncology, 13(Suppl. 5), 174.
    Fortner, B.V., Tauer, K., Zhu, L., Okon, T.A., Moore, K., Templeton, D., et al. (2004). Medical visits for chemotherapy and chemotherapy-induced neutropenia: A survey of the impact on patient time and activities. BMC Cancer, 4, 22.
    Glaspy, J., Hackett, J., Flyer, P., Dunford, D., & Liang, B. (2001, December). Febrile neutropenia is associated with an increase in the incidence, duration, and severity of chemotherapy toxicities. Poster presented at the American Society of Hematology Annual Meeting, Orlando, FL.
    Goodwin, P.J., Black, J.T., Bordeleau, L.J., & Ganz, P.A. (2003). Healthrelated quality-of-life measurement in randomized clinical trials in breast cancer—Taking stock. Journal of the National Cancer Institute, 95, 263-281.
    Green, M.D., Koelbl, H., Baselga, J., Galid, A., Guillem, V., Gascon, P., et al. (2003). A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy. Annals of Oncology, 14, 29-35.
    Higginson, I.J., & Carr, A.J. (2001). Measuring quality of life: Using quality of life measures in the clinical setting. BMJ, 322, 1297-1300.
    Holmes, F.A., O'Shaughnessy, J.A., Vukelja, S., Jones, S.E., Shogan, J., Savin, M., et al. (2002). Blinded, randomized, multicenter study to evaluate single administration pegfilgrastim once per cycle versus daily filgrastim as an adjunct to chemotherapy in patients with high-risk stage II or stage III/IV breast cancer. Journal of Clinical Oncology, 20, 727-731.
    Hwang, S.S., Scott, C.B., Chang, V.T., Cogswell, J., Srinivas, S., & Kasimis, B. (2004). Prediction of survival for advanced cancer patients by recursive partitioning analysis: Role of Karnofsky performance status, quality of life, and symptom distress. Cancer Investigation, 22, 678-687.
    Jensen, M.P. (2003). The validity and reliability of pain measures in adults with cancer. Journal of Pain, 4, 2-21.
    Kramer, J.A., Curran, D., Piccart, M., de Haes, J.C., Bruning, P., Klijn, J., et al. (2000). Identification and interpretation of clinical and quality of life prognostic factors for survival and response to treatment in first-line chemotherapy in advanced breast cancer. European Journal of Cancer, 36, 1498-1506.
    Kuderer, N.M., Crawford, J., Dale, D.C., & Lyman, G.H. (2005). Metaanalysis of prophylactic granulocyte colony-stimulating factor (G-CSF) in cancer patients receiving chemotherapy [Abstract 8117]. Journal of Clinical Oncology, 23(Suppl. 16S), 758S.
    Kwak, L.W., Halpern, J., Olshen, R.A., & Horning, S.J. (1990). Prognostic significance of actual dose intensity in diffuse large-cell lymphoma: Results of a tree-structured survival analysis. Journal of Clinical Oncology, 8, 963-977.
    Larson, E., & Nirenberg, A. (2004). Evidence-based nursing practice to prevent infection in hospitalized neutropenic patients with cancer. Oncology Nursing Forum, 31, 717-725.
    Levine, M.N., & Ganz, P.A. (2002). Beyond the development of quality-of-life instruments: Where do we go from here? Journal of Clinical Oncology, 20, 2215-2216.
    Lubeck, D.P., Kim, H., Grossfeld, G., Ray, P., Penson, D.F., Flanders, S.C., et al. (2001). Health related quality of life differences between black and white men with prostate cancer: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor. Journal of Urology, 166, 2281-2285.
    Lyman, G.H., & Kuderer, N.M. (2002). Filgrastim in patients with neutropenia: Potential effects on quality of life. Drugs, 62(Suppl. 1), 65-78.
    Maisey, N.R., Norman, A., Watson, M., Allen, M.J., Hill, M.E., & Cunningham, D. (2002). Baseline quality of life predicts survival in patients with advanced colorectal cancer. European Journal of Cancer, 38, 1351-1357.
    MAPI Research Institute. (2006). PROQOLID. Retrieved February 9, 2007, from http://www.proqolid.org
    Martin, M., Lluch, A., Segui, M., Anton, A., Fernandez-Chacon, C., Ruiz, A., et al. (2005). Toxicity and health-related quality of life (HRQoL) in nodenegative breast cancer (BC) patients (pts) receiving adjuvant treatment with TAC (docetaxel, doxorubicin, cyclophosphamide) or FAC (5-fluorouracil, doxorubicin, cyclophosphamide): Impact of adding prophylactic growth factors (GF) to TAC [Abstract 604]. GEICAM Study 9805. Journal of Clinical Oncology, 24(Suppl. 16S), 29s.
    Montazeri, A., Milroy, R., Hole, D., McEwen, J., & Gillis, C.R. (2001). Quality of life in lung cancer patients: As an important prognostic factor. Lung Cancer, 31, 233-240.
    Mullen, K.H., Berry, D.L., & Zierler, B.K. (2004). Computerized symptom and quality-of-life assessment for patients with cancer part II: Acceptability and usability [Online exclusive]. Oncology Nursing Forum, 31, E84-E89. Retrieved January 26, 2007, from http://www.ons.org/publications/journals/ONF/Volume31/Issue5/3105896.asp
    National Comprehensive Cancer Network. (2007). NCCN clinical practice guidelines in oncology: Myeloid growth factors. v.1.2007. Retrieved February 9, 2007, from http://www.nccn.org/professionals/physician_gls/PDF/myeloid_growth.pdf
    Okon, T.A., Fortner, B.V., Schwartzberg, L., Tauer, K.T., Durrence, H., Kovacs, A., et al. (2002). Quality of life (QOL) in patients with grade IV chemotherapy-induced neutropenia (CIN) [Abstract 2920]. Proceedings of the American Society of Clinical Oncology, 21, 275b.
    Padilla, G., & Ropka, M.E. (2005). Quality of life and chemotherapy-induced neutropenia. Cancer Nursing, 28, 167-171.
    Payne, S., Jarrett, N., & Jeffs, D. (2000). The impact of travel on cancer patients' experiences of treatment: A literature review. European Journal of Cancer Care (England), 9, 197-203.
    Picozzi, V.J., Pohlman, B.L., Morrison, V.A., Lawless, G.D., Lee, M.W., Kerr, R.O., et al. (2001). Patterns of chemotherapy administration in patients with intermediate-grade non-Hodgkin's lymphoma. Oncology, 15, 1296-1306.
    Roychowdhury, D.F., Hayden, A., & Liepa, A.M. (2003). Health-related quality-of-life parameters as independent prognostic factors in advanced or metastatic bladder cancer. Journal of Clinical Oncology, 21, 673-678.
    Sloan, J.A., Cella, D., Frost, M.H., Guyatt, G., & Osoba, D. (2003). Quality of life III: Translating the science of quality-of-life assessment into clinical practice—An example-driven approach for practicing clinicians and clinical researchers. Clinical Therapeutics, 25(Suppl. D), D1-D5.
    Sprangers, M.A., Cull, A., Bjordal, K., Groenvold, M., & Aaronson, N.K. (1993). The European Organization for Research and Treatment of Cancer. Approach to quality of life assessment: Guidelines for developing questionnaire modules. EORTC Study Group on Quality of Life. Quality of Life Research, 2, 287-295.
    Viens, M., De Koninck, J., Mercier, P., St-Onge, M., & Lorrain, D. (2003). Trait anxiety and sleep-onset insomnia: Evaluation of treatment using anxiety management training. Journal of Psychosomatic Research, 54, 31-37.
    Ware, J., Jr., Kosinski, M., & Keller, S.D. (1996). A 12-item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220-233.
    Yellen, S.B., Cella, D.F., Webster, K., Blendowski, C., & Kaplan, E. (1997). Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of Pain and Symptom Management, 13, 63-74.
    Zigmond, A.S., & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatricta Scandinavica, 67, 361-370.
    Ropka, M.E. (2002). Symptoms status and functional status outcomes: Humanistic outcomes in obesity disease management. Obesity Research, 10(Suppl. 1), 42S-49S.
    Ropka, M.E., Padilla, G., & Gillespie, T.W. (2005). Risk modeling: Applying evidence-based risk assessment in oncology nursing practice. Oncology Nursing Forum, 32, 49-56.