Effect of chemotherapy counseling by pharmacists on quality of life and psychological outcomes of oncology patients in Malaysia: a randomized control trial

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Abstract

Background

Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia.

Method

A single-blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on ‘Managing Patients on Chemotherapy’ by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow-up and second follow-up and third follow-up post-intervention. Chi-square, independent samples t-test and two-way repeated measures ANOVA were conducted in the course of the data analyses.

Results

In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health ( p = 0.001, partial Ƞ ² = 0.66), psychological ( p = 0.001, partial Ƞ ² = 0.65), social relationships ( p = 0.001, partial Ƞ ² = 0.30), and environment ( p = 0.001, partial Ƞ ² = 0.67) and decrease in the anxiety ( p = 0.000; partial Ƞ ² = 0.23), depression ( p = 0.000; partial Ƞ ² = 0.40).

Conclusion

The module on ‘Managing Patients on Chemotherapy’ along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy.

Trial registration number

National Medical Research Register (NMRR) of Malaysia and given a registration number NMRR-12-1057-12,363 on 21 December 2012.

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Most cited references 27

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Fundamentals of biostatistics

Rosner, Bernard, A Bernard … (2011)

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Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial.

William Carson, Maibritt B. Andersen, Timothy R Crespin … (2004)

This randomized clinical trial tests the hypothesis that a psychological intervention can reduce emotional distress, improve health behaviors and dose-intensity, and enhance immune responses. We studied 227 women who were surgically treated for regional breast cancer. Before adjuvant therapy, women completed interviews and questionnaires assessing emotional distress, social adjustment, and health behaviors. A 60-mL blood sample was drawn for immune assays. Patients were randomly assigned to either the intervention group or assessment only group. The intervention was conducted in small patient groups, with one session per week for 4 months. The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Reassessment occurred after completion of the intervention. As predicted, patients receiving the intervention showed significant lowering of anxiety, improvements in perceived social support, improved dietary habits, and reduction in smoking (all P <.05). Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability (ie, more dispersion in the dose-intensity values) for the assessment arm (P <.05). Immune responses for the intervention patients paralleled their psychological and behavioral improvements. T-cell proliferation in response to phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients, whereas both responses declined for Assessment patients; this effect was replicated across three concentrations for each assay (all P <.01). These data show a convergence of significant psychological, health behavior, and biologic effects after a psychological intervention for cancer patients.

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Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia

Zobaida Edib, Verasingam Kumarasamy, Norlia binti Abdullah … (2016)

Background Addressing breast cancer patients’ unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients’ characteristics, and their unmet supportive care needs. Methods A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants’ socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Results The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Conclusion Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.

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Author and article information

Contributors

Ummavathy Periasamy: umma145@gmail.com

Sherina Mohd Sidik: +603-89472530 , sherina@upm.edu.my

Lekhraj Rampal: lekhraj@upm.edu.my

Siti Irma Fadhilah: Irma@upm.edu.my

Mehrnoosh Akhtari-Zavare: akhtari_mehrnoosh@yahoo.com

Rozi Mahmud: rozi@upm.edu.my

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 15 May 2017

Publication date PMC-release: 15 May 2017

Publication date Collection: 2017

Volume: 15

Electronic Location Identifier: 104

Affiliations

[1 ]Hospital Tuanku Jaafar, Seremban, Negeri Symbian Malaysia

[2 ]ISNI 0000 0001 2231 800X, GRID grid.11142.37, Cancer Resource & Education Center, , Universiti Putra Malaysia, ; 43400 Serdang, Selangor Malaysia

[3 ]ISNI 0000 0001 2231 800X, GRID grid.11142.37, Department of Psychiatry, Faculty of Medicine & Health Sciences, , Universiti Putra Malaysia, ; 43400 Serdang, Selangor Malaysia

[4 ]ISNI 0000 0001 2231 800X, GRID grid.11142.37, Department of Community Health, Faculty of Medicine & Health Sciences, , Universiti Putra Malaysia, ; 43400 Serdang, Selangor Malaysia

[5 ]ISNI 0000 0001 0706 2472, GRID grid.411463.5, Department of Public Health, Tehran Medical Sciences Branch, , Islamic Azad University, ; Tehran, Iran

Article

Publisher ID: 680

DOI: 10.1186/s12955-017-0680-2

PMC ID: 5433062

PubMed ID: 28506305

SO-VID: 42d37d1d-9c57-485f-a32e-5f5f246247b4

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 28 December 2016

Date accepted : 9 May 2017

Funding

Funded by: Research University Grant Scheme

Award ID: (RUGS), Grant # 04-02-12-2095RU

Funded by: Malaysian Medical Association Fund (MMAF)

Award ID: Grant#MMAF RG/08/2012

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: cancer,chemotherapy,quality of life,psychological outcomes,counseling,pharmacist,malaysia

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ScienceOpen disciplines: Health & Social care

Keywords: cancer, chemotherapy, quality of life, psychological outcomes, counseling, pharmacist, malaysia

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Effect of chemotherapy counseling by pharmacists on quality of life and psychological outcomes of oncology patients in Malaysia: a randomized control trial

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Karger: Oncology

Most cited references 27

Fundamentals of biostatistics

Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial.

Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia

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