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Title: Risk factors for current and future unmet supportive care needs of people with pancreatic cancer. A longitudinal study
Authors: Beesley V; Wockner L; O'Rourke P; Janda M; Goldstein D; Gooden H; Merrett N; O’Connell DL; Rowlands I; Wyld D; Neale R
Categories: Cancer Control, Survivorship, and Outcomes Research - Patient Care and Survivorship Issues
Cancer Type - Pancreatic Cancer
Year: 2016
Journal Title: Supportive Care in Cancer
Volume: 24
Issue: 8
Page number start: 3589
Page number end: 3599
Abstract: Purpose This study aims to determine if the supportive care needs of people with pancreatic cancer change over time and identify the factors associated with current and future unmet needs. Methods Australian pancreatic cancer patients completed a self-administered survey at 0–6 months post-diagnosis (n = 116) then follow-up surveys 2 (n = 82) and 4 months (n = 50) later. The validated survey measured 34 needs across five domains. Weighted generalised estimating equations were used to identify factors associated with having ≥1 current or future moderate-to-high unmet need. Results The overall proportion of patients reporting ≥1 moderate-or-high-level need did not significantly change over time (baseline = 70 % to 4 months = 75 %), although there was a non-significant reduction in needs for patients who had a complete resection (71 to 63 %) and an increase in patients with locally advanced (73 to 85 %) or metastatic (66 to 88 %) disease. Higher levels of pain (OR 6.1, CI 2.4–15.3), anxiety (OR 3.3, CI 1.5–7.3) and depression (OR 3.2, CI 1.7–6.0) were significantly associated with current needs. People with pain (OR 4.9, CI 1.5–15.4), metastatic disease (OR 2.7, CI 0.7–10.0) or anxiety (OR 2.5, CI 0.7–8.6) had substantially higher odds of reporting needs at their next survey. The prevalence of needs was highest in the physical/daily living and psychological domains (both 53 % at baseline). Pain and anxiety had respectively the strongest associations with these domains. Conclusions Careful and continued attention to pain control and psychological morbidity is paramount in addressing significant unmet needs, particularly for people with metastatic disease. Research on how best to coordinate this is crucial.
Division: Cancer Research Division
Funding Body: QPCS and the patient-reported outcome sub-study were supported by the National Health and Medical Research Council of Australia (project nos. 442302 and 613654 respectively). VL Beesley was funded by a Rio Tinto Ride to Conquer Cancer grant. M Janda was funded by a NHMRC Career Development Fellowship (no. 1045247). RE Neale is funded by an NHMRC Senior Research Fellowship (no. 1060183).
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