Monitoring Oral Cancer Patients’ QOL Concerns in Routine Clinical Practice

Objective: To pilot a computerized web-based Patients Concerns Inventory (PCI) in a hospital-based oral and maxillofacial specialist clinic in Malaysia  to monitor oral cancer patients’ QOL related concerns during their consultation visits. Method:  The web-based computerized touch screen version of the Malaysian PCI was piloted in one oral-maxillofacial specialist clinic for 3-6 months.  All oral cancer patients attending the specialist clinic during the period were included. The PCI checklist was administered through a face-to face interview prior to consultation sessions. Patients were asked to select their QOL related concerns that they wished to discuss with their specialists for that visit. Patient data captured by the touchscreen included their socio-demographic details; their QOL concerns categorized in 5 domains and two general questions to assess patients’ overall QOL perception. Specialists feedback regarding the usefulness of the computerised PCI was assessed too.  Data was analysed in SPSS (v 16.0). Result: A total of 101 PCI were filled. The sample consisted of almost equal proportions of elderly (48.5%) and (46.5%) middle age, 70% female and 80% Indians. Three most frequent patient concern domains to be discussed during consultation were physical issues; personal function and diet whereas finance was the least. Patients’ concerns about pain in their head/neck; sleep disturbance; shoulder stiffness; diet restriction and salivation were five main specific issues whereas hair loss, relationship with others and family support were the least.  Lifestyle, carer/home care and spiritual issues were not of concern at all. Overall, three-quarters of patients reported very good/good QOL. Majority (90%) reported QOL improvement. Surgeons gave positive feedback about the usefulness of the computerized PCI in helping focus their consultation, agreeing to its future use. Conclusion: The computerized PCI was successfully piloted to monitor oral cancer patients’ concerns during  consultation thus favoring  its future use for routine clinical care.