Health-Related Quality of Life among Patients with Oral Potentially Malignant Disorder and Oral Cancer in Malaysia
Authors:   Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia, Raman Sivaraj ,   Centre for Health Economics Research, Institute for Health Systems Research, National Institutes of Health, 40170 Shah Alam, Selangor, Malaysia, Shafie Asrul Akmal ,   Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia,   Institutional Planning and Strategic Center, Universiti Sains Malaysia, 11800 Pulau Pinang, Malaysia, Abraham Mannil Thomas ,   Oral and Maxillofacial Surgery Department, Hospital Tengku Ampuan Rahimah, Ministry of Health, 41200 Klang, Selangor, Malaysia, Kiong Shim Chen ,   Oral and Maxillofacial Surgery Department, Hospital Umum Sarawak, Ministry of Health, 93586 Kuching, Sarawak, Malaysia, Maling Thaddius Herman ,   Samarahan Divisional Dental Office, Sarawak State Health Department, Ministry of Health, 94300 Kota Samarahan, Sarawak, Malaysia, Rajendran Senthilmani ,   Digital Health Research Unit, Cancer Research Malaysia, 47500 Subang Jaya, Selangor, Malaysia, Cheong Sok Ching ,   Digital Health Research Unit, Cancer Research Malaysia, 47500 Subang Jaya, Selangor, Malaysia,   Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
Published: June 2022

Presently there is a lack of health-related quality of life (HRQOL) measure and its corresponding utility values for oral cancer and oral potentially malignant disorders (OPMD). This limits patient-centered outcomes for cost-effectiveness evaluations. The study aimed to determine post-treatment HRQOL of patients and ascertained differences between OPMD, early and late-stage oral cancer. A crosssectional survey was conducted among patients in oral maxillofacial specialist clinics in two public tertiary hospitals. Consented participants were required to complete the EQ-5D-5L questionnaire with the EQ Visual Analogue System (VAS). Kruskal-Wallis test was used to explore differences in values between stages. Multiple linear regression was used to explore factors that influenced the HRQOL. A total of 50 OPMD and 52 oral cancer patients were surveyed. The mean EQ-5D 5L health utility values was 0.842 (n = 50, SD = 0.139), 0.822 (n = 10, SD = 0.150) and 0.626 (n = 42, SD = 0.310) for OPMD, early- and late-stage cancer, respectively. The mean values of the EQ-5D-5L index and EQ-VAS scale showed significant differences between groups and between early- and late-stage cancer with good discriminative properties. Results of the multiple linear regression indicated that ethnicity, income, residency, diagnosis, and treatment modality were able to significantly account for 25% of EQ-5D-5L utility values, F(10,91) = 3.83, p < 0.001, R2 = 0.360. Indian ethnicity, rural location, income less than RM4,360, late-stage cancer, and multi-modal therapies were all predictors of poorer HRQOL. This study evidenced disease severity and treatment modality to greatly impact the HRQOL of patients, in addition to socio-demographic factors such as ethnicity and income.