Evaluating quality of life outcomes in metastatic breast cancer: Effects of palliative home visits in northern Malaysia.

Abstract

e13090 Background: Metastatic breast cancer (MBC) causes significant symptom burden and psychological distress especially in Northern Malaysia where access to palliative care is limited. With 16,430 new cases (2017–2021) and 22.2% presenting at stage IV, effective supportive interventions are needed. Universiti Sains Malaysia Medical Center Bertam pioneered volunteer-integrated palliative home visits, yet their impact on patients’ quality of life (QoL) remains unevaluated. Methods: This prospective study enrolled 81 adults with MBC in Northern Malaysia to complete a 12-week volunteer-integrated palliative home visit program (Oct 2024 to Jan 2026). Serial visits by healthcare professionals and trained volunteers provided symptom management, psychosocial support and practical assistance. QoL was assessed at baseline and 12 weeks using EORTC QLQ-C15-PAL, with item-specific changes analysed using descriptive statistics, paired t -tests and Cohen’s d . Results: Participants were predominantly middle-aged women (34% aged 40–49 years; 64% B40 income group). Of 94 recruited, 81 completed (13 excluded for mortality or progression). At baseline, none were in ECOG 4, but 38% progressed to ECOG 4 at 3 months. QoL outcomes showed improvements across all symptoms and functioning domains. Statistically significant improvements observed in physical functioning, appetite loss, and fatigue (Δ +7.47, p < 0.001; Δ −9.00, p < 0.001; Δ−10.67, p = 0.01), although the corresponding effect sizes were small to moderate. Constipation and dyspnea also showed statistically significant but small improvements (Δ -4.67; Δ -2.01; both p < 0.001). Insomnia, pain and emotional functioning showed moderate effect size improvements; however, not reach statistical significance (Table 1). Conclusions: This study showed that palliative home visits improved overall QoL and symptom control among patients with MBC in Northern Malaysia, supporting its efficacy in community-based palliative care models Pre- and post-intervention quality of life outcomes (EORTC QLQ-C15-PAL). EORTC QLQ-C15-PAL items Pre-intervention Mean (SD) Post intervention Mean (SD) p-value a Effect size (d) b Insomnia 34.35 (30.74) 16.01 (17.81) 0.48 -0.70 Pain 52.00 (28.8) 38.65 (28.86) 0.09 -0.46 Physical Functioning 50.66 (31.46) 58.13 (26.51) 0.00 0.25 Appetite Loss 32.35 (32.36) 23.35 (29.92) 0.00 -0.29 Fatigue 50.88 (24.31) 40.21 (24.39) 0.01 -0.44 Constipation 21.68 (28.42) 17.01 (23.93) 0.00 -0.18 Emotional Functioning 63.18 (29.06) 76.84 (27.26) 0.19 0.49 Nausea/Vomiting 20.01 (26.08) 13.68 (17.72) 0.62 -0.29 Dyspnea 18.02 (22.8) 16.01 (17.81) 0.00 -0.10 Global QoL 61.35 (26.85) 68.34 (21.36) 0.12 0.28 a Paired t -test b Cohen’s d was interpreted as small (0.20–0.49), moderate (0.50–0.79) and large (≥0.80); positive values indicate improvement in functioning/QoL and negative values indicate symptom improvement.