Quality of life study for HAH patients

Methods:

481 hospital-at-home (HAH) patients were asked about their quality of life using the validated EQ-5D-3L questionnaire (1). Patients self-assessed their state of health using a visual analog scale (VAS), and their quality of life using 5 questions on the dimensions of mobility, autonomy, daily activities, pain, anxiety/depression. A specific analysis of palliative care patients was carried out.

Results:

54 palliative care patients participated. 32 women / 22 men - mean age 68 years (19 - 93 years). 76% suffered from cancer and 24% from another pathology. 22% are undergoing cancer chemotherapy.

The mean VAS of perceived health status was 51.05 (min 0 - max 90).

81% of patients have their mobility affected, 69% their daily activities, 69% their autonomy.87% have pain. 63% anxiety or depression.

Age and gender have little influence. The VAS is less degraded for cancer (53.65 vs. 43.07 for other pathologies) and the same trend appears for the 5 dimensions. Chemotherapy did not worsen VAS (55.94 vs. 51.59 without chemo).

Follow-up by a specialized palliative care team is associated with less anxiety-depression (50% vs. 73%), and similarly when the attending physician comes to the home (59% vs. 73%).

Discussion:

The mean VAS of perceived health status of the palliative care population is only slightly worse than that of the total population (58.85). The wide dispersion of results nevertheless shows the variability of patients' feelings, with some considering themselves to be in good health while their state of health is objectively very degraded.

The 5 dimensions are all more degraded than the total population, with the greatest difference concerning autonomy (69% vs. 34%). Close follow-up (attending physician, SP teams) seems to be associated with a reduction in psychological difficulties.

Overall, cancer seems to be associated with a better quality of life than other diseases. Perhaps this is linked to the quality of the organization of city-hospital care in this pathology (HDJ, networks..) and the tight network of cancer services in Ile-de-France.

Conclusions:

Our study demonstrates that it is possible to be in a palliative situation and experience a satisfactory quality of life, despite the objective deteriorations observed by caregivers. It also shows the importance of local follow-up and of the quality of the link between those working in the city and in the hospital.

Our study shows that it is possible to be in a palliative situation and experience a satisfactory quality of life, despite the objective deterioration observed by carers