Association of patient activation with the health-related quality of life of pancreatic cancer patients

The study aimed to evaluate patient activation, HRQOL, and the association between these two constructs for patients with pancreatic cancer. A cross-sectional study design was used to assess patient activation and HRQOL of locally advanced and metastatic pancreatic cancer patients. Patients undergoing chemotherapy sessions at 13 Texas Oncology clinics were approached to participate in the study via convenience sampling. Patients willing to participate were provided with a 43-item survey to complete. The survey consisted of the 13-item patient activation measure (PAM-13), the 18-item functional assessment of cancer therapy-hepatobiliary symptom index (FHSI-18), and single-item measures of clinical and demographic variables. Variables were analyzed descriptively by assessing mean, median, and frequencies. Relationships between variables were assessed using bivariate statistics. The response rate was high (95.4%). The average age of the participants was 71.1 ± 9.5 years. The majority were females (57.1%), Caucasians (58.5%), had at least a college degree (57.2%), were married or partnered (61.9%), and had an annual household income of over $50,000 (60%). Clinically, most patients were diagnosed at stage 4 (39.0%), had no family history of the disease (87.8%), and were diagnosed less than three months prior to survey completion (46.3%). The mean patient activation score was 62.8 ± 18.5 (range 0-100), with most patients at higher patient activation levels, i.e., stage 3 or stage 4 (66.7%). The mean HRQOL score of 42 (range: 0-72) was low. Bivariate analysis revealed significantly high patient activation scores for patients with multiple insurances and those that were married or partnered. Patients that were high school graduates or less and those that had public insurance were more likely to be at a lower activation level (stages 1 or 2). Patient activation scores had a non-significant, weak positive correlation with HRQOL scores. The predictive ability of patient activation score at predicting HRQOL score while controlling for covariates was not assessed due to the low sample size. The results indicate a non-significant association between patient activation and HRQOL, though the study was significantly underpowered. Higher patient activation was significantly associated with having private insurance and being partnered. Research amongst larger and more diverse samples is required for conclusive evidence