Determinants of self-reported functional status (EPIC-26) in prostate cancer patients prior to treatment

Abstract

Purpose The self-reported functional status (sr-FS) of prostate cancer (PCa) patients varies substantially between patients and health-care providers before treatment. Information about this issue is important for evaluating comparisons between health-care providers and to assist in treatment decision-making. There have been few reports on correlates of pretherapeutic sr-FS. The objective of the article, therefore, is to describe clinical and sociodemographic correlates of pretherapeutic sr-FS, based on a subset of the TrueNTH Global Registry, a prospective cohort study. Methods A total of 3094 PCa patients receiving local treatment in 44 PCa centers in Germany were recruited between July 2016 and April 2018. Multilevel regression models were applied to predict five pretherapeutic sr-FS (EPIC-26) scores based on clinical characteristics (standard set suggested by the International Consortium for Health Outcomes Measurement), sociodemographic characteristics, and center characteristics. Results Impaired pretherapeutic sr-FS tended to be associated with lower educational level and poorer disease characteristics-except for "urinary incontinence" which was only associated with age. Notably, age was a risk factor ("urinary incontinence," "urinary irritative/obstructive," "sexual") as well as a protective factor ("hormonal") for pretherapeutic sr-FS. Pretherapeutic sr-FS varies little across centers. Conclusions Pretherapeutic sr-FS varies by clinical patient characteristics and age as well as by socioeconomic status. The findings point out the benefit of collecting and considering socioeconomic information in addition to clinical and demographic patient characteristics for treatment decision-making and fair comparisons between health-care providers.

High Neuroticism Is Related to More Overall Functional Problems and Lower Function Scores in Men Who Had Surgery for Non-Relapsing Prostate Cancer

“…However, none of these studies included analyses of overall problems (bother). As to pre-treatment findings on the EPIC-26 in men with PCa, a recent German study only reported on dysfunctional AOHs and not on overall problems [ 28 ].…”

Use of psycho‐oncological services by prostate cancer patients: A multilevel analysis

“…The patients included in the present study were relatively young, 26 slightly better educated, and with an above‐average rate of private insurance coverage in comparison with the overall population of patients with prostate cancer in Germany, and this needs to be taken into consideration before the results are generalized (Kowalski et al, unpublished data, 2019). In addition, the analysis includes a large number of missing values for numbers of comorbidities, partly due to the way in which comorbidity data are collected, as mentioned above (Kowalski et al, unpublished data, 2019) 27 . Since the default value in the documentation system is zero, patients are considered to have no comorbidities if no information is given.…”

“…In addition, the analysis includes a large number of missing values for numbers of comorbidities, partly due to the way in which comorbidity data are collected, as mentioned above (Kowalski et al, unpublished data, 2019). 27 Since the default value in the documentation system is zero, patients are considered to have no comorbidities if no information is given. For centers that did not modify the default value of zero for any of their patients, the number of comorbidities was therefore treated as a missing value for all of the patients from those centers in the analysis.…”

Mapping disadvantage: identifying inequities in functional outcomes for prostate cancer survivors based on geography

“…Despite increasing socioeconomic disadvantage and remoteness both predicting for worse functional outcome following prostate cancer treatment, only socioeconomic disadvantage remains an independent predictor after controlling for confounding factors: older age [ 33 ] as well as higher risk disease and treatment [ 34 ] have previously been linked to poor functional outcomes and it was unsurprising to find these associated to functional outcomes in our data. Whilst remoteness does indeed predict worse functional outcome, our analysis suggests that this results from the interrelation between remoteness and socioeconomic disadvantage, the latter being the underlying driver of poor functional outcome.…”