Understanding the impact of percutaneous endoscopic gastrostomy on patient and caregiver well-being: A health-related quality-of-life assessment in indian population.

INTRODUCTION

Percutaneous endoscopic gastrostomy (PEG) is an established method for providing long-term enteral nutrition. While its clinical utility is well recognized, its impact on health-related quality-of-life (HRQoL) in both patients and caregivers, particularly in India, remains insufficiently characterized. This study aims to assess HRQoL in Indian patients undergoing PEG placement and their caregivers using both generic and PEG-specific assessment tools.

METHODS

This prospective observational cohort study was conducted at a tertiary center in Bengaluru, India, from July 2021 to March 2023. Total 80 patients undergoing PEG placement and their primary caregivers were enrolled. HRQoL was assessed pre-procedure and at eight to 12 weeks post-procedure using the EuroQol-5D-3L questionnaire for both patients and caregivers. Additionally, patients completed the PEG-specific NutriQoL questionnaire at Day 3 post-procedure and at eight to 12 weeks.

RESULTS

A majority of patients (81.3%) had head and neck cancers, while others had neurological dysphagia. Patients with head and neck cancer demonstrated a statistically significant decrease in EuroQol Index post-procedure (mean difference: -0.10, 95% CI: -0.13 to -0.07, p < 0.001), whereas patients with neurological dysphagia showed improvement (0.62 to 0.67, p = 0.004). NutriQoL scores showed statistically significant improvement across all patient groups over two to three months post-PEG (mean score change from -15.55 to 18.54; p < 0.001). Caregivers exhibited a statistically significant decline in EuroQol Index post-procedure (0.98 to 0.93; p < 0.001), with employed caregivers reporting lower HRQoL compared to unemployed caregivers.

CONCLUSION

PEG placement appears to have differential impact on generic HRQoL depending on the underlying clinical condition, while nutritional quality of life appears to improve over time in our cohort of patients. In caregivers, generic HRQoL declined over time especially among those balancing caregiving and employment. These findings underscore the need for comprehensive pre-procedure counselling, structured caregiver support and indigenous, culturally tailored nutritional interventions to optimize outcomes in the Indian context.