Use of support services in a sample of patients with high-risk primary melanomas in urban, regional and rural Queensland

von Schuckmann, Lena A., Smithers, Bernhard M., Khosrotehrani, Kiarash, Beesley, Vanessa L., van der Pols, Jolieke C., Hughes, Maria B. and Green, Adele C. (2017) Use of support services in a sample of patients with high-risk primary melanomas in urban, regional and rural Queensland. Australian and New Zealand Journal of Public Health, 41 3: 315-319. doi:10.1111/1753-6405.12662


Author von Schuckmann, Lena A.
Smithers, Bernhard M.
Khosrotehrani, Kiarash
Beesley, Vanessa L.
van der Pols, Jolieke C.
Hughes, Maria B.
Green, Adele C.
Title Use of support services in a sample of patients with high-risk primary melanomas in urban, regional and rural Queensland
Journal name Australian and New Zealand Journal of Public Health   Check publisher's open access policy
ISSN 1753-6405
1326-0200
Publication date 2017-03-28
Year available 2017
Sub-type Article (original research)
DOI 10.1111/1753-6405.12662
Open Access Status DOI
Volume 41
Issue 3
Start page 315
End page 319
Total pages 5
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2739 Public Health, Environmental and Occupational Health
Abstract Objective: To characterise use of support services in patients diagnosed with high-risk primary melanoma by their location of residence. Methods: In a cross-sectional study of 787 patients with histologically-confirmed clinical stage 1B-2 melanoma, we estimated odds ratios (ORs) using regression models to assess the association of support service use with residence in rural, regional or urban areas. We also evaluated demographic and clinical correlates of support service use. Results: Among 113 rural patients, 33 (29%) used support services around time of diagnosis compared to 88 (39%) of 224 regional participants and 164 of 448 (37%) urban participants. Regional participants more commonly used support services compared to rural participants (OR 1.84; CI 1.09-3.10), but there was no association with urban versus rural residence (OR 1.32; CI 0.82-2.13). As well, females (OR 1.58; CI 1.15-2.18), those <65 years (OR 1.96; CI 1.42-2.71), or with higher education (OR 2.30; CI 1.53-3.44), or those with T-stage 4B (OR 2.69; CI 1.36-5.32) were more likely to use support services than other patients. Conclusion: Use of support services is lower among rural patients and other sub-groups of primary melanoma patients who have poorer prognoses than others. Implications for public health: Appropriate triage to support services is required for rural and other vulnerable patient groups to ensure optimal patient care.
Formatted abstract
Objective: To characterise use of support services in patients diagnosed with high-risk primary melanoma by their location of residence.

Methods: In a cross-sectional study of 787 patients with histologically-confirmed clinical stage 1B-2 melanoma, we estimated odds ratios (ORs) using regression models to assess the association of support service use with residence in rural, regional or urban areas. We also evaluated demographic and clinical correlates of support service use.

Results: Among 113 rural patients, 33 (29%) used support services around time of diagnosis compared to 88 (39%) of 224 regional participants and 164 of 448 (37%) urban participants. Regional participants more commonly used support services compared to rural participants (OR 1.84; CI 1.09-3.10), but there was no association with urban versus rural residence (OR 1.32; CI 0.82-2.13). As well, females (OR 1.58; CI 1.15-2.18), those <65 years (OR 1.96; CI 1.42-2.71), or with higher education (OR 2.30; CI 1.53-3.44), or those with T-stage 4B (OR 2.69; CI 1.36-5.32) were more likely to use support services than other patients.

Conclusion: Use of support services is lower among rural patients and other sub-groups of primary melanoma patients who have poorer prognoses than others.

Implications for public health: Appropriate triage to support services is required for rural and other vulnerable patient groups to ensure optimal patient care.
Keyword High-risk patients
Melanoma
Queensland
Remoteness of residence
Support services
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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