THE DEVELOPMENT OF AN INTERDISCIPLINARY ASSESSMENT CLINIC TO ADDRESS THE HEALTH RELATED QUALITY OF LIFE (HRQOL) ISSUES OF PATIENTS WITH A MENINGIOMA

Evidence demonstrating the impact a meningioma brain tumour may have on the HRQOL of a patient undergoing neurosurgery has supported the development of an interdisciplinary assessment clinic and highlighted their therapeutic and supportive care needs. Meningiomas are often benign, yet they can have a complex presentation. NICE (2006) recommend that supportive care should be available for all brain tumour patients, however this can be limited for patients with a meningioma, as surgery is deemed to be curative and support has focussed on patients with malignant tumours. Self-reported HRQOL outcomes are now recognised as providing further understanding of the effects of the condition and treatments. The interdisciplinary clinic provides comprehensive Neuropsychology and Allied Health Professional assessment before and after surgery. The clinic, alongside addressing their needs, provides understanding of the physical and psychosocial effects of the tumour, to support rationalised clinical decision-making for proceeding with surgery. The HRQOL of 30 consecutive patients attending the interdisciplinary clinic were compared before and six months following surgery using the FACT-BR, a disease-specific PROM and both were compared to normal controls. The HRQOL of patients before and following surgery was significantly lower than normal controls. The HRQOL of 60% of patients improved and 40% deteriorated following surgery, although this was not statistically significant. The main issues before and following surgery were identified. These results support that patients with a meningioma experience HRQOL issues, indicating the need for an interdisciplinary clinic to address their therapeutic and supportive care needs. The increase in incidental findings due to more frequent neuroimaging has also raised the importance of the need for careful consideration of the risk/benefits for proceeding with surgery, due to the potential negative impact on HRQOL, as conservative management may be preferable in some instances due to the slow-growing nature of the tumour.