Comparison of quality-adjusted life years (QALYs) of end-stage patients with gastrointestinal cancers receiving conventional therapies with recipients of supportive-palliative care package

Abstract

OBJECTIVE: This study aimed to compare the quality-adjusted life years (QALYs) of patients with gastrointestinal (GI) cancer after receiving palliative and supportive care. MATERIALS AND METHODS: Conducted at Firoozgar Hospital in Tehran, Iran, this observational study included 500 end-stage gastrointestinal cancer patients. The study divided these patients into two groups: 250 utilized palliative medicine services, while the remaining 250 did not. The study compared the conditions of patients in both groups. Results: Among those receiving palliative care, only 21% underwent chemotherapy, significantly lower than the 55% in the non-palliative care group (P < 0.001). Hospital mortality rates were considerably reduced in the palliative care group, with 115 patients (46%) compared to 200 patients (80%) in the non-palliative group (P < 0.001). The average hospital stay for patients receiving palliative care was 25.11 ± 5.12 days, significantly shorter than the 96.42 ± 14.15 days in the non-palliative group (P < 0.001). The EuroQol 5-Dimensions 3-Levels (EQ-5D-3L) questionnaire scores showed that patients in the palliative care group experienced significantly better outcomes in pain and mood symptoms, but no significant difference was observed in physical function compared to the non-palliative group. Conclusion: Palliative medicine is recommended for gastrointestinal cancer patients as it can significantly reduce unnecessary hospital referrals and length of hospitalization.

Keywords

• cancer
• gastrointestinal tract
• palliative care
• quality of life