The Association Between an Electronic Health Record (EHR)-Embedded Frailty Index and Patient-Reported Outcomes Among Patients with Metastatic Non-Small-Cell Lung Cancer on Immunotherapy: A Brief Report.
Jennifer Gabbard, Saadia Nur, Beverly J Levine and 6 others
PMID 38133583WHAT IT FOUND
Among patients with metastatic non-small-cell lung cancer on immunotherapy, pre-frail and frail patients reported more pain and worse physical function than fit patients.
Overall quality of life, treatment goals, and palliative care referrals did not differ by frailty.
Key findings
01Pre-frail and frail patients reported worse physical function than fit patients, with mean scores of 83.9 for fit, 74.8 for pre-frail, and 60.0 for frail.
02Frail patients reported more pain: 75% had at least moderate pain, compared with 41.5% of pre-frail and 18.2% of fit patients.
03Frailty groups did not differ in overall quality of life, treatment goals, perceived likelihood of cure, palliative care referrals, or unmet supportive care needs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only sixty patients were studied at one academic medical center. The survey was cross-sectional, so it cannot show that frailty caused worse pain or function. Patients received different immunotherapy agents, lines, and other treatments, so results cannot be separated from treatment variation. Small numbers meant some comparisons, such as smoking differences, could not be judged reliably. The study did not test frailty-based assessment, exercise, physical therapy, or palliative care referral decisions.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not read the frailty groups as having different palliative care referral rates or as proof that frailty causes worse pain. The study was cross-sectional, small, and referral rates did not differ by frailty.