Risk factors for current and future unmet supportive care needs of people with pancreatic cancer. A longitudinal study

Beesley, Vanessa L., Wockner, Leesa F., O'Rourke, Peter, Janda, Monika, Goldstein, David, Gooden, Helen, Merrett, Neil D., O'Connell, Dianne L., Rowlands, Ingrid J., Wyld, David K. and Neale, Rachel E. (2016) Risk factors for current and future unmet supportive care needs of people with pancreatic cancer. A longitudinal study. Supportive Care in Cancer, 24 8: 3589-3599. doi:10.1007/s00520-016-3212-4


Author Beesley, Vanessa L.
Wockner, Leesa F.
O'Rourke, Peter
Janda, Monika
Goldstein, David
Gooden, Helen
Merrett, Neil D.
O'Connell, Dianne L.
Rowlands, Ingrid J.
Wyld, David K.
Neale, Rachel E.
Title Risk factors for current and future unmet supportive care needs of people with pancreatic cancer. A longitudinal study
Journal name Supportive Care in Cancer   Check publisher's open access policy
ISSN 1433-7339
0941-4355
Publication date 2016-08
Year available 2016
Sub-type Article (original research)
DOI 10.1007/s00520-016-3212-4
Open Access Status Not Open Access
Volume 24
Issue 8
Start page 3589
End page 3599
Total pages 11
Place of publication Heidelberg, Germany
Publisher Springer Verlag
Collection year 2017
Language eng
Formatted 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.
Keyword Anxiety
Depression
Longitudinal study
Pain
Pancreatic cancer
Risk factors
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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