Abstract / Summary
Abstract Purpose Assessing health-related quality of life (HRQoL) in patients receiving palliative care (PC) is an essential cornerstone in providing PC. Here, we aim to describe HRQoL of PC patients with cancer from South Africa (SA) and the Democratic Republic of the Congo (DRC). Methods This cross-sectional study assessed HRQoL using the EORTC QLQ-C15-PAL in PC cancer patients from SA and DRC. Data was merged with Austrian and Spanish patients serving as exploratory controls. We estimated the prevalence of clinically important problems using established thresholds and calculated odds ratios (OR). ANOVA and ANCOVA models (adjusting for age, sex, and comorbidities) investigated systematic score differences across countries and a general linear model investigated country-specific covariate interactions. Results We enrolled 103 patients (SA: n = 61, mean age 66.3; DRC: n = 42, mean age 55.1). Clinically important problems were highly prevalent: 68.9% of SA patients reported impaired physical function, and 95.0% of DRC patients reported clinically important pain. Compared to European controls, ORs for clinically important problems ranged from 0.7 for insomnia to 7.8 for constipation. Significant country-level differences persisted for physical functioning, pain, dyspnoea, and constipation (p < 0.05) after adjustment for covariates. Age, sex, and comorbidities showed country-specific associations with various HRQoL domains, including Emotional functioning, Global Quality of Life, Fatigue, Pain, Sleep Disturbance and Appetite loss. Conclusion High scores for symptoms that are typically considered manageable may indicate a need to improve palliative care services and support the advocacy for universally accessible PC solutions in SA and the DRC.