COMPASS: Costs and Medical Care of Patients with Advanced Serious Illness in Singapore
Eric Finkelstein, Executive Director, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Rebecca Dent, Nesaretnam Barr Kumarakulasinghe, Lee Lai Heng, Irene Teo Eng Ai, Chetna Malhotra Semra Özdemir, Rahul Malhotra, Cheung Yin Bun, Nivedita Nadkarni, Alethea Yee, Grace Yang, Ravindran Kanesvaran,
Patricia Yeo, Noreen Chan, Wu Huei Yaw, Chin Soh Mun, Hum Yin Mei Allyn, Wee Lee Yeo, Richard Harding
In Singapore, little is known about the experiences of patients with advanced cancer, such as quality of care received and how patients transition across different health care settings, or about the factors that
influence patient and caregiver quality of life. This study, is a first-of-its-kind longitudinal study in Singapore to prospectively capture health care utilization, cost, quality of care and quality of life indicators
for a sample of patients with advanced cancer, their primary informal caregivers and their physicians using both administrative and survey data collected until patient’s death.
The primary objective of this study is to describe trajectories of quality of life of patients with advanced cancer and their predictors, to describe the transitions between care settings for such patients and to
quantify healthcare utilization and costs. Secondary objectives are to investigate preferences for diagnostic and prognostic information, preferences in end of life care, perceived quality of care, and to assess the
areas of burden reported by caregivers over time as patients approach end of life.
Prospective study of patients with advanced cancer. 650 patients and their primary informal caregivers are followed every 3 months until death of patient. Treating physicians of the patients are invited to take part in
National Cancer Centre Singapore
National University Hospital
The results from this study will help assess patient and caregiver preferences for end-of-life care, perceived quality of communication with the physicians and the extent to which pain and other symptoms are adequately
managed in patients. Each of these is a priority area identified in Singapore’s National Strategy for Palliative Care as having significant knowledge gaps.
Teo I, Singh R, Malhotra C, Ozdemir S, Dent RA, Kumarakulasinghe NB, Yeo WL, Cheung YB, Malhotra R, Kanesvaran R, Yee ACP, Chan N, Wu HY, Soh MC, Hum AYM, Yang GMJ, Soek PHN, Nadkarni N, Harding R, Finkelstein EA. BMC Cancer.2018;18:459.
Ozdemir S, Malhotra C, Teo I, Yang GM, Kanesvaran R, YEE ACP, Finkelstein EA. Annals Academy of Medicine, Singapore.2019; 48(8):241-246.
Teo I, Baid D, Ozdemir S, Malhotra C, Singh R, Harding R, Malhotra R, Yang GM, Neo SHS, Cheung YB, Neo PSH, Kanesvaran R, Kumarakulasinghe NB, Lee LH, Koh G, Finkelstein EA, COMPASS study group. BMJ Supportive & Palliative Care.2019. Published Online First. doi.org/10.1136/bmjspcare-2019-001979.
Malhotra C, Harding R, Teo I, Ozdemir S, Koh GCH, Neo P, Lee LH, Kanesvaran R, Finkelstein EA, COMPASS study group. Supportive Care in Cancer.2020; 28(8):3781-3789.
Doble, B., Wong, W., Finkelstein, E., & COMPASS study team (2021). Palliative medicine, 269216321999576. Advance online publication. https://doi.org/10.1177/0269216321999576
Ozdemir, S., Ng, S., Malhotra, C., Teo, I., Finkelstein, E. A., & COMPASS Study Group (2021). Innovation in aging, 5(3), igab020Z. https://doi.org/10.1093/geroni/igab020
Malhotra, C., Chaudhry, I., Ozdemir, S., Teo, I., Kanesvaran, R., & COMPASS Study Group (2021). Cancer, 10.1002/cncr.33592. Advance online publication. https://doi.org/10.1002/cncr.33592
Malhotra, C., Koh, L. E., Teo, I., Ozdemir, S., Chaudhry, I., Finkelstein, E., & COMPASS Study Team (2021). Journal of the National Comprehensive Cancer Network : JNCCN, jnccn20334. Advance online publication. https://doi.org/10.6004/jnccn.2020.7795
Malhotra, C., Malhotra, R., Bundoc, F., Teo, I., Ozdemir, S., Chan, N., & Finkelstein, E. (2021). Journal of the National Comprehensive Cancer Network : JNCCN, 1–8. Advance online publication. https://doi.org/10.6004/jnccn.2021.7014
Ozdemir, S., Tian, Y., Malhotra, C., Harding, R., Koh, G., Kumarakulasinghe, N. B., Lee, L. H., Mon, S. W., Finkelstein, E., & COMPASS Study Group (2021). The patient, 10.1007/s40271-020-00480-1. Advance online publication. https://doi.org/10.1007/s40271-020-00480-1
Shafiq, M., Malhotra, R., Teo, I., Ozdemir, S., Kanesvaran, R., Malhotra, C., & COMPASS Study Group (2021). Psycho-oncology, 10.1002/pon.5792. Advance online publication. https://doi.org/10.1002/pon.5792
Webinar 31 August 2020
||PDF / Video link
COMPASS Study Webinar Part 1: Introduction
Prof Eric Andrew Finkelstein gives a short introduction of the COMPASS Cohort Study.
COMPASS Study Webinar Part 2: Asst Prof Semra Ozdemir
Asst Prof Semra Ozdemir discusses the following topics:
Awareness of palliative care services
Discordance between experienced and preferred role in decision making
COMPASS Study Webinar Part 3: Asst Prof Chetna Malhotra
Asst Prof Chetna Malhotra discusses the following topics:
Instability in preferences for end of life care
COMPASS Study Webinar Part 4: Asst Prof Irene Teo
Asst Prof Irene Teo discusses the following topics:
Caregiving for advanced cancer patients: Psychological outcomes and protective factors
Bereavement adjustment of caregivers
COMPASS Study Webinar Part 5: Prof Eric Andrew Finkelstein
Prof Eric Andrew Finkelstein talks about healthcare costs at the end-of-life.
||Webinar Slide Deck (pdf)
Project Start Date:
18 January 2016