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events, tumour response, and survival would be desired by 100%, 97%, and 80% of
patients. The information on these items in the decision aid was desired by 95%,
91%, and 74% of patients. The question of whether the doctor had disclosed the
information was answered positively by 72%, 53%, and 28% of patients. Results of
the association between patient’s information desire and demographic, clinical, and
psychological measures will be presented.
Conclusions: Even in this advanced setting, most patients accepted all information
in the decision aid. Patients perceived that the oncologists had not disclosed all
desired information. While oncologists accurately judged that patients in this study
had a high information desire, their judgment of information desire on tumour
response and survival for an individual patient was no better than could be expected
by chance. These results demonstrate the importance of ascertaining a patient’s
information desire, and communicating more candid, especially on survival.
Disclosure: All authors have declared no conflicts of interest.
1470P FAMILY CAREGIVER BURDEN: RESULTS OF A MOROCCAN
PROSPECTIVE STUDY OF CANCER IN THE ELDERLY AND
THEIR CAREGIVERS
S. Lkhoyaali 1 , M. Ait El Haj 2 , S. Raissouni 3 , G. Rais 1 , H. Mrabti 3 and H. Errihani 3
1 Medical Oncology, National Institut of Oncology, Rabat, MOROCCO, 2 National
Institute of Oncology, INO, Rabat, MOROCCO, 3 Medical Oncology, Institut
National d’Oncologie Sidi Mohamed Ben Abdellah, Rabat, MOROCCO
Introduction: The support of older patients affected with cancer by their natural
caregivers is not a simple task. It could be a painful experience with a major
emotional, physical and economic impact on relatives. Usually family members do
that task and they may not be prepared for the challenges. The needs of older
patients are diverse and may include assistance with medication, transportation for
treatment, and emotional support.
Methods: This is a prospective descriptive study, conducted in the National Institute
of Oncology in Rabat during a ten month period from December 2010 to September
2011.We included relatives of patients aged 70 or older with histologically proven
cancer and also their relatives. A questionnaire was given to participants. For all
participants, demographics, disease characteristics, social, economical and
psychological features were recorded. Psychological impact was assessed using
DSM-IV.
Findings: A total of 150 patients’ relative caregivers responded to the questionnaire.
Mean age was 44.7 years old. More than two thirds live in urban areas and educated in
62.7%. They were 56.7% sons or daughters, living with their relatives in 54% of cases.
Most of participants were married and have familial responsibilities. In relatives,
anxiety was found in 79.3%. It was related to fear of losing the patient in 57% and led
to the use of anxiolytics in 10%. Guilty feelings toward patients regarding neglecting
early symptoms was reported in 38% of the relatives. Depression and anxiety were
more frequent among female relatives and in those of urban origin. Obsession with
dying from cancer was present in about 30% and fear of contagion was more common
among those from rural backgrounds and the illiterate. Economic resources were
exceeded in 78.7%, and 56% have used credit, sale of properties and work lay-off was
recorded in 54%. Relatives participated in treatment making decisions in 86%.
Conclusion: Even where there was a great impact on older cancer patients’ relatives,
the benefits of caregiving was observed in 80% in our study, these included greater
self-esteem, personal growth, meaning and purpose in one’s life, and gratitude for
being able to reciprocate care. Assistance and information from healthcare
professionals remains the key to improving the ability of caregivers to cope with
caring for older patients with cancer.
Disclosure: All authors have declared no conflicts of interest.
1471P ANNOUNCING CANCER IN A DEVELOPING COUNTRY: HOW
IS IT DIFFERENT?
R. Belbaraka 1 , A. Mahfoudi 1 , M. Khouchani 2 and A. Tahri 2
1 Centre Oncologie Hematologie, Cadi Ayad University, Marrakech, MOROCCO,
2 CHU, Mohamed Vi, University Cadi Ayyad, Marrakech, MOROCCO
Background: Announcing a cancer diagnosis, but also a relapse, a progression of the
disease, or transition towards palliative care constitute particularly difficult
communication issues for the patient as well as for the clinician, during the
trajectory of care. The study aimed to describe the difficulties in establishing a
“good” announcing consultation, to provide indications or even recommendations on
the ways to facilitate communication in order to ensure a optimal quality of care,
responding to patients needs and ensuring the continuity of the care.
Patients and methods: A semi-directive questionnaire with 21 items in Arabic were
conducted in patients with cancer to evaluate their perception of the announcement
of cancer.
Results: 189 patients aged 18-78 years participated in the questionnaire. Participation
was on a voluntary basis and patients were informed they could be accompanied by
an outside person if they wished. The analysis revealed that several factors
determined the quality of the relation as perceived by the patient receiving the
Annals of Oncology
announcement of cancer: the relationship between the patient and the physician
prior to the announcement, the practitioner’s consideration of the role of others
(family, friends) close to the patient, the practitioner’s respect of the patient’s desire
for information, and the modalities of the announcement. Modalities considered to
be favorable were: the physician’s empathy and availability, a progressive
announcement using clear terms, presence of family or friends at the time of the
announcement if desired by the patient, absence of half-truths or lies.
Conclusion: Announcing a diagnosis of cancer is a major challenge to the
physician’s technical competence and human qualities. This is probably one of the
greatest challenges that we have to face in oncology. This work confirmed that better
knowledge of the patient’s experience is useful for examining our practices for
announcing the diagnosis of cancer.
Disclosure: All authors have declared no conflicts of interest.
1472P WHAT MOROCCAN CANCER ELDERLY PATIENTS WANT
TO KNOW
S. Raissouni 1 , S. Lkoyaali 1 , G. Rais 1 , M. Aitelhaj 2 , H. Mouzount 2 , H. Mrabti 1 and
H. Errihani 1
1 Medical Oncology, National Institute of Oncology, Rabat, MOROCCO, 2 Medical
Oncology, INO, Rabat, MOROCCO
Introduction: Announcing cancer to a patient is not a simple task. Usually doctors
fail to inform patients about this diagnosis and this is still more likely in older
people. The need of information in elderly cancer patients is not well established. In
developed countries the majority of old patients demand exhaustive information
about their disease. However in developing countries where social and cultural issues
are different, perception of cancer in the elderly is not well studied. Therefore we
conducted a prospective study on the needs of elderly Moroccan cancer patients for
information about their disease.
Methods: This was a prospective descriptive study, conducted in the National
Institute of Oncology of Morocco (December 2010-September 2011). Cancer patients
older than 70 were included. A questionnaire was given to participants.
Demographics, disease characteristics, social and economic features were recorded.
Informed consent was required.
Results: 150 patients responded to the questionnaire. Mean age was 73. Men to
woman sex-ratio 0.85. 72.7% of patients were diagnosed in advanced stages. Illiteracy
was found in 76%. 87.3% of patients did not have health insurance. All patients were
Muslim, practicing in 97%. 57% ignored diagnosis. 80% didn’t want to know further
information about prognosis and treatment side effects. Family protection from
information was found in 70%.
Conclusion: Elderly Moroccans affected with cancer are less demanding of details
about their illness. Illiteracy and cultural background may play major roles in this.
Protection by relatives is also an influence. Comparative studies with young patients
are needed.
Disclosure: All authors have declared no conflicts of interest.
1473P PATIENT PREFERENCE, ADHERENCE AND OUTCOMES
IN ONCOLOGY: DEVELOPMENT OF A THEORETICAL MODEL
S.L. Shingler 1 , B. Bennett 1 , J. Cramer 2 , C. Twelves 3 , A. Towse 4 and A.J. Lloyd 1
1 Patient Reported Outcomes, Oxford Outcomes, An ICON PLC Company,
Oxford, UNITED KINGDOM, 2 School of Medicine, Yale University, New Haven,
CT, UNITED STATES OF AMERICA, 3 Leeds Institute of Molecular Medicine & St
James’s Institute of Oncology, St James’s University Hospital, Leeds, UNITED
KINGDOM, 4 Health Economics, Office of Health Economics, London, UNITED
KINGDOM
Introduction: A patient’s preference may guide their behaviour and influence their
treatment outcomes. However, the importance of understanding patient preferences
within oncology is unclear. The present study was designed to review the literature
regarding preferences, adherence and their link to outcomes specifically in the
oncology setting and to propose a theoretical model.
Methodology: Published data examining patient preference, adherence and
outcomes, specific to oncology, from 1982 to 2012, was searched for in Embase,
Medline and Cochrane Library databases. Articles were then reviewed independently
by two researchers and rated on their relevance and quality. Information from the
retrieved literature and discussion with experts in the fields of oncology and patient
preference, informed the development of the theoretical model.
Results: The search yielded 2359 abstracts, of which 93 were reviewed in detail after
de-duplication and abstract review. Evidence from the highest quality and most
relevant articles (n = 19) were included in the development of the theoretical model.
Relationships between patient preference, adherence and clinical outcomes/HRQoL
were found to exist. Adverse effects (AEs) were found to have a strong relationship
with adherence. Patient beliefs and values were also identified as having a moderating
effect on adherence.
Discussion: This review identified external and cognitive variables related to patient
preference, adherence behaviour and outcome, which are included in the theoretical
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