The effect of patient self-reported confidence on psychosocial outcomes in the context of lymphoma and chronic lymphocytic leukaemia.

Abstract

7074 Background: Adverse psycho-social outcomes (APSO’s) are common side effects often underreported which have great impact on the wellbeing of patients with lymphoma or chronic lymphocytic leukemia (CLL). As patient’s traverse through their unique cancer journey, relationships with their care team yield varying degrees of confidence. We explored how confidence in both the management of their care and in the doctor coordinating their care was associated with various APSO’s. Methods: A cross-sectional, anonymous online global survey directed at patients with lymphoma or CLL was deployed in 2024. Two questions asked how confident the patient feels about 1) the management of their care (MOC) and 2) the doctor coordinating their care (DCC). Patients were split into dichotomous groups who were and were not confident. Nominal logistic regression was used to explore how answers to these two questions influenced the prevalence of 19 different APSO’s controlling for age and biological sex. Results were expressed in odds ratios with 95% confidence intervals. Results: Responses were received from 5,186 patients with 64% female and a median age of 61 [20-96]. Significantly increased incidence of APSO’s associated with a lack of confidence in the MOC included: conflicts between beliefs and cancer treatment OR = 2.3 [1.4 – 3.6]; loss of meaning/purpose OR = 1.9 [1.5 – 2.4]; depression OR = 1.7 [1.4 – 1.99]; grief/loss OR = 1.6 [1.3 – 1.96]; loss of interest in usual activities OR = 1.6 [1.3 – 1.9]; post-traumatic stress disorder OR = 1.5 [1.2 – 1.98]; isolation/loneliness OR = 1.5 [1.3 – 1.9]; feelings of worthlessness/being a burden OR = 1.5 [1.2 – 1.9]; loss of self-esteem OR 1.5 [1.2 – 1.8]; anxiety OR = 1.5 [1.2 – 1.7]; fear of incapacitation OR = 1.4 [1.1 – 1.7]; changes in relationships OR = 1.3 [1.1 – 1.6]; worry OR = 1.3 [1.1 – 1.5]. APSO’s that significantly increased due to a lack of confidence in DCC included: anger OR = 1.6 [1.2 – 2.0]; isolation/loneliness OR = 1.5 [1.2 – 1.9]; fear of incapacitation OR = 1.5 [1.1 - 1.9]. The remaining APSO’s examined failed to produce significant differences regarding patient confidence levels. This analysis illustrates that approximately 73% of the APSO’s reviewed in our survey had significant odds of being associated with patients who reported a lack of confidence in their MOC or the DCC. Conclusions: These results suggest that patients with low confidence in the management of their care plan and in the doctor coordinating their care may disproportionately experience APSO’s. It is important that care teams take time to build relationships with their patients to help reinforce confidence in their care. In doing so the patient might experience fewer APSO’s. Going forward, we plan to explore the effect of general practitioner involvement on patient confidence and the effect confidence has on physical side effects experienced by patients with lymphoma and CLL.