Cost and Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS),is a cohort study which aims to capture health care utilization, cost, and quality of life indicators of patients with advanced cancer and their primary caregivers.
The study will recruit 600 patients with advanced cancer, their primary informal caregivers and their treating physicians. Eligible patients will be recruited from study-sites in Singapore and will be followed until death. Patients and their consenting primary informal caregivers will be interviewed first at baseline and then every 3 months thereafter until the patient's death. A post-death interview with primary informal caregiver will be conducted at 8th week and 6 months after the patient's death. As the majority of the care during last year of life is provided by hospices, the eligible patients will be followed as they receive treatment and care at various hospices. Treating physicians of the patients will be invited to take part in the study. They will be asked to answer a survey conducted only once during the duration of the study. Data on medical expenditures incurred by a patient from diagnosis of advanced cancer until death will be collected. With patient consent, these data will be extracted every 6 months from the time of patient enrolment from relevant databases, including hospitals and hospices.
Study Type
OBSERVATIONAL
Enrollment
600
National Cancer Centre Singapore
Singapore, Singapore
National University Hospital
Singapore, Singapore
Change in overall quality of life among patients through the last year of life.
We will assess patient's quality of life through FACT-G
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Change in anxiety and depression among patients through the last year of life
We will assess patients' anxiety and depression through the Hospital Anxiety and Depression Scale (HADS).
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Change in pain severity among patients through the last year of life
We will assess pain reported by patients through visual analog pain scores
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Change in activities of daily living among patients through the last year of life
We will assess limitations in activities of daily living of patients through OARS Multidimensional Functional Assessment Questionnaire
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Change in patient's perceived quality of care during the last year of life
We will describe patients' assessment of their own care using a scale used by Ayanian et al (JCO, 2010) that consists of 13 questions.
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Total health care expenditure during the last year of life through analysis of medical bills
We will calculate total health care expenditure during the last year of patient's life as the sum total of expenditures incurred at clinics etc.
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
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Change in patient's awareness of prognosis by asking if the patients believe that their current treatment regimen is likely to cure them of cancer
We will assess knowledge of disease by asking the extent to which advanced cancer patients understand the severity of their condition and if the patients believe that a treatment regimen is available that could cure them
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Change in caregiver burden through the last year of life
We will assess caregiver burden through modified Caregiver Reaction Assessment Scale Instrument
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Change in caregiver's levels of emotional distress through the last year of life
We will assess caregiver's anxiety and depression through the Hospital Anxiety and Depression Scale (HADS).
Time frame: From recruitment to death of patient (baseline, 3 month, 6 months, 9 months, 12 months)
Caregiver's perception of patient's end-of-life care assessed after patient's death
We will assess caregiver perceived quality of end-of-life care through Caregiver Evaluation of the Quality of End-Of- Life Care( CEQUEL)
Time frame: 8 weeks bereavement
Caregivers bereavement adjustment assessed after patient's death
Post-patient death bereavement adjustment will be assessed through Brief Grief Questionnaire
Time frame: 6 months bereavement