Top

Supportive Care in Cancer

Published in:

Open Access 01-02-2012 | Review Article

The unfulfilled promise: a systematic review of interventions to reduce the unmet supportive care needs of cancer patients

Authors: Mariko Carey, Sylvie Lambert, Rochelle Smits, Chris Paul, Rob Sanson-Fisher, Tara Clinton-McHarg

Published in: Supportive Care in Cancer | Issue 2/2012

Abstract

Purpose

This review aimed to examine (a) trends in the number of publications on unmet needs over time and (b) the effectiveness of interventions designed to reduce unmet needs among cancer patients.

Methods

An electronic literature search of Medline to explore trends in the number of publications on patients’ unmet needs and an additional literature search of Medline, CINAHL, PsychINFO, and Web of Science databases to identify methodologically rigorous research trials that evaluated interventions to reduce unmet needs were conducted.

Results

Publications per year on unmet needs have increased over time, with most being on descriptive research. Nine relevant trials were identified. Six trials reported no intervention effect. Three trials reported that intervention participants had a lower number of unmet needs or lower unmet needs score, compared to control participants. Of these, one study found that the intervention group had fewer supportive care needs and lower mean depression scores; one study found that intervention participants with high problem-solving skills had fewer unmet needs at follow-up; and one study found an effect in favor of the intervention group on psychological need subscale scores.

Conclusions

Reasons for varying results across trials and the limited effectiveness of unmet needs interventions are more broadly discussed. These include inadequacies in psychometric rigor, problems with scoring methods, the use of ineffective interventions, and lack of adherence to intervention protocols.

Carlson LE, Angen M, Cullum J, Goodey E, Koopmans J, Lamont L, MacRae JH, Martin M, Pelletier G, Robinson J, Simpson JSA, Speca M, Tillotson L, Bultz BD (2004) High levels of untreated distress and fatigue in cancer patients. Br J Cancer 90(12):2297–2304. doi:10.1038/sj.bjc.6601887 PubMed

Zaboraa J, Brintzenhofeszoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-Oncology 10(1):19–28CrossRef

National Breast Cancer Centre and National Cancer Control Initiative (2003) Clinical practice guidelines for the psychosocial care of adults with cancer. Available at http://www.nhmrc.gov.au/publications/synopses/cp90synhtm. Accessed 2011

Fitch M (2000) Supportive care for cancer patients. Hosp Q 3(4):39–46PubMed

Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Supportive Care Review Group. Cancer 88(1):226–237. doi:10.1002/(SICI)1097-0142(20000101)88:1<226::AID-CNCR30>3.0.CO;2-P PubMedCrossRef

Wen K, Gustafson D (2004) Needs assessment for cancer patients and their families. Health Qual Life Outcomes 2:11. doi:10.1186/1477-7525-2-11 PubMedCrossRef

Girgis A, Boyes A, Sanson-Fisher RW, Burrows S (2000) Perceived needs of women diagnosed with breast cancer: rural versus urban location. Aust NZ J Public Health 24(2):166–173. doi:10.1111/j.1467-842X.2000.tb00137.x CrossRef

Sutherland G, Hill D, Morand M, Pruden M, McLachlan SA (2009) Assessing the unmet supportive care needs of newly diagnosed patients with cancer. Eur J Cancer Care (Engl) 18(6):577–584. doi:10.1111/j.1365-2354.2008.00932.x CrossRef

Tamburini M, Gangeri L, Brunelli C, Boeri P, Borreani C, Bosisio M, Karmann C, Greco M, Miccinesi G, Murru L, Trimigno P (2003) Cancer patients’ needs during hospitalisation: a quantitative and qualitative study. BMC Cancer 3(1):12PubMedCrossRef

10.

Clavarino AM, Lowe JB, Carmont S-A, Balanda K (2002) The needs of cancer patients and their families from rural and remote areas of Queensland. Aust J Rural Heal 10(4):188–195. doi:10.1046/j.1440-1584.2002.00436.x CrossRef

11.

Lintz K, Moynihan C, Steginga S, Norman A, Eeles R, Huddart R, Dearnaley D, Watson M (2003) Prostate cancer patients’ support and psychological care needs: survey from a non-surgical oncology clinic. Psycho-Oncology 12(8):769–783. doi:10.1002/pon.702 PubMedCrossRef

12.

Davis C, Williams P, Redman S, White K, King E (2003) Assessing the practical and psychosocial needs of rural women with early breast cancer in Australia. Soc Work Health Care 36(3):25–36PubMedCrossRef

13.

Soothill K, Morris SM, Harman J, Francis B, Thomas C, McIllmurray MB (2001) The significant unmet needs of cancer patients: probing psychosocial concerns. Support Care Cancer 9(8):597–605. doi:10.1007/s005200100278 PubMedCrossRef

14.

Steginga SK, Occhipinti S, Dunn J, Gardiner RA, Heathcote P, Yaxley J (2001) The supportive care needs of men with prostate cancer (2000). Psycho-Oncology 10(1):66–75. doi:10.1002/1099-1611(200101/02)10:1<66::aid-pon493>3.0.co;2-z PubMedCrossRef

15.

Chen SC, Yu WP, Chu TL, Hung HC, Tsai MC, Liao CT (2010) Prevalence and correlates of supportive care needs in oral cancer patients with and without anxiety during the diagnostic period. Cancer Nurs 33(4):280–289. doi:10.1097/NCC.0b013e3181d0b5ef PubMedCrossRef

16.

McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK (2010) Predictors of change in unmet supportive care needs in cancer. Psychooncology 19(5):508–516. doi:10.1002/pon.1604 PubMedCrossRef

17.

Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A (2000) Evaluation of an instrument to assess the needs of patients with cancer. Supportive Care Review Group. Cancer 88(1):217–225. doi:10.1002/(SICI)1097-0142(20000101)88:1<217::AID-CNCR29>3.0.CO;2-Y PubMedCrossRef

18.

Rainbird KJ, Perkins JJ, Sanson-Fisher RW (2005) The Needs Assessment for Advanced Cancer Patients (NA-ACP): a measure of the perceived needs of patients with advanced, incurable cancer. a study of validity, reliability and acceptability. Psychooncology 14(4):297–306. doi:10.1002/pon.845 PubMedCrossRef

19.

Campbell HS, Sanson-Fisher R, Turner D, Hayward L, Wang XS, Taylor-Brown J (2010) Psychometric properties of cancer survivors’ unmet needs survey. Support Care Cancer 19(2):221–230. doi:10.1007/s00520-009-0806-0 PubMedCrossRef

20.

Carey M, Clinton-McHarg T, Sanson-Fisher R, Shakeshaft A (2011) Development of cancer needs questionnaire for parents and carers of adolescents and young adults with cancer. Support Care in Cancer. doi:10.1007/s00520-011-1172-2

21.

Girgis A, Lambert S, Lecathelinais C (2011) The supportive care needs survey for partners and caregivers of cancer survivors: development and psychometric evaluation. Psycho-Oncology 20(4):387–393. doi:10.1002/pon.1740 PubMedCrossRef

22.

Hodgkinson K, Butow P, Hobbs KM, Hunt GE, Lo SK, Wain G (2007) Assessing unmet supportive care needs in partners of cancer survivors: the development and evaluation of the Cancer Survivors’ Partners Unmet Needs measure (CaSPUN). Psycho-Oncology 16(9):805–813. doi:10.1002/pon.1138 PubMedCrossRef

23.

Sanson Fisher R, Carey M, Paul CL (2009) Measuring the unmet needs of those with cancer: a critical overview. Cancer Forum 33(3)

24.

Curry C, Cossich T, Matthews JP, Beresford J, McLachlan SA (2002) Uptake of psychosocial referrals in an outpatient cancer setting: improving service accessibility via the referral process. Support Care Cancer 10(7):549–555. doi:10.1007/s00520-002-0371-2 PubMedCrossRef

25.

Minstrell M, Winzenberg T, Rankin N, Hughes C, Walker J (2008) Supportive care of rural women with breast cancer in Tasmania, Australia: changing needs over time. Psychooncology 17(1):58–65. doi:10.1002/pon.1174 PubMedCrossRef

26.

Campbell HS, Sanson-Fisher R, Taylor-Brown J, Hayward L, Wang XS, Turner D (2009) The cancer support person’s unmet needs survey: psychometric properties. Cancer 115(14):3351–3359. doi:10.1002/cncr.24386 PubMedCrossRef

27.

Tamburini M, Gangeri L, Brunelli C, Beltrami E, Boeri P, Borreani C, Fusco Karmann C, Greco M, Miccinesi G, Murru L, Trimigno P (2000) Assessment of hospitalised cancer patients’ needs by the Needs Evaluation Questionnaire. Ann Oncol 11(1):31–37PubMedCrossRef

28.

Cochrane Effective Practice and Organisation of Care Group (2007) Cochrane Effective Practice and Organisation of Care Group (EPOC). Data collection checklist. Available at http://epoc.cochrane.org/sites/epoc.cochrane.org/files/uploads/datacollectionchecklist.pdf. Accessed 12 April 2011

29.

White VM, Macvean ML, Grogan S, D’Este C, Akkerman D, Leropoli S, Hill DJ, Sanson-Fisher R (2011) Can a tailored, needs based intervention delivered by volunteers reduce the needs, anxiety and depression of people with colorectal cancer? A randomized controlled trial. Psychooncology. doi:10.1002/pon.2019

30.

Aranda S, Schofield P, Weih L, Milne D, Yates P, Faulkner R (2006) Meeting the support and information needs of women with advanced breast cancer: a randomised controlled trial. Br J Cancer 95(6):667–673. doi:10.1038/sj.bjc.6603320 PubMedCrossRef

31.

Girgis A, Breen S, Stacey F, Lecathelinais C (2009) Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. J Clin Oncol 27(36):6180–6190. doi:10.1200/jco.2009.22.8718 PubMedCrossRef

32.

King M, Jones L, McCarthy O, Rogers M, Richardson A, Williams R, Tookman A, Nazareth I (2009) Development and pilot evaluation of a complex intervention to improve experienced continuity of care in patients with cancer. Br J Cancer 100(2):274–280. doi:10.1038/sj.bjc.6604836 PubMedCrossRef

33.

Scandrett KG, Reitschuler-Cross EB, Nelson L, Sanger JA, Feigon M, Boyd E, Chang CH, Paice JA, Hauser JM, Chamkin A, Balfour P, Stolbunov A, Bennett CL, Emanuel LL (2010) Feasibility and effectiveness of the NEST13+ as a screening tool for advanced illness care needs. J Palliat Med 13(2):161–169. doi:10.1089/jpm.2009.0170 PubMedCrossRef

34.

Macvean ML, White VM, Pratt S, Grogan S, Sanson-Fisher R (2007) Reducing the unmet needs of patients with colorectal cancer: a feasibility study of The Pathfinder Volunteer Program. Support Care Cancer 15(3):293–299. doi:10.1007/s00520-006-0128-4 PubMedCrossRef

35.

McLachlan SA, Allenby A, Matthews J, Wirth A, Kissane D, Bishop M, Beresford J, Zalcberg J (2001) Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. J Clin Oncol 19(21):4117–4125PubMed

36.

Boyes A, Newell S, Girgis A, McElduff P, Sanson-Fisher R (2006) Does routine assessment and real-time feedback improve cancer patients’ psychosocial well-being? Eur J Cancer Care 15(2):163–171. doi:10.1111/j.1365-2354.2005.00633.x CrossRef

37.

Allen SM, Shah AC, Nezu AM, Nezu CM, Ciambrone D, Hogan J, Mor V (2002) A problem-solving approach to stress reduction among younger women with breast carcinoma—a randomized controlled trial. Cancer 94(12):3089–3100. doi:10.1002/cncr.10586 PubMedCrossRef

38.

Sanson-Fisher RW, Campbell EM, Htun AT, Bailey LJ, Millar CJ (2008) We are what we do: research outputs of public health. Am J Prevent Med 35(4):380–385CrossRef

39.

Boyes A, Girgis A, Lecathelinais C (2009) Brief assessment of adult cancer patients’ perceived needs: development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34). J Eval Clin Pract 15(4):602–606. doi:10.1111/j.1365-2753.2008.01057.x PubMedCrossRef

40.

Pearce NJ, Sanson-Fisher R, Campbell HS (2008) Measuring quality of life in cancer survivors: a methodological review of existing scales. Psycho-Oncology 17(7):629–640. doi:10.1002/pon.1281 PubMedCrossRef

41.

Boyes A, Hodgkinson K, Aldridge L, Turner J (2009) Issues for cancer survivors in Australia. Cancer Forum 33(3):164–167

42.

Twombly R (2004) What’s in a name: who is a cancer survivor? J Natl Cancer Inst 96(19):1414–1415. doi:10.1093/jnci/96.19.1414 PubMed

43.

Hewitt M, Greenfield S, Stovall E (2005) From cancer patient to cancer survivor: lost in translation. The National Academies Press, Washington

44.

Wen K, McTavish F, Kreps G, Wise M, Gustafson D (2011) From diagnosis to death: a case study of coping with breast cancer as seen through online discussion group messages. J Comput-Mediat Commun 16(2):331–361. doi:10.1111/j.1083-6101.2011.01542.x CrossRef

45.

Hodgkinson K, Butow P, Hunt GE, Pendlebury S, Hobbs KM, Lo SK, Wain G (2007) The development and evaluation of a measure to assess cancer survivors’ unmet supportive care needs: the CaSUN (Cancer Survivors’ Unmet Needs measure). Psychooncology 16(9):796–804. doi:10.1002/pon.1137 PubMedCrossRef

46.

McElduff P, Boyes A, Zucca A, Girgis A (2004) Supportive care needs survey: a guide to administration, scoring and analysis. Centre for Health Research and Psycho-oncology, Newcastle

47.

Rehse B, Pukrop R (2003) Effects of psychosocial interventions on quality of life in adult cancer patients: meta-analysis of 37 published controlled outcomes studies. Patient Educ Couns 50:179–186PubMedCrossRef

48.

Coyne JC, Lepore SJ, Palmer SC (2006) Efficacy of psychosocial interventions in cancer care: evidence is weaker than it first looks. Ann Behav Med 32(2):104–110. doi:10.1207/s15324796abm3202_5 PubMedCrossRef

49.

Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, Palmer N, Ream E, Young A, Richardson A, Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, Palmer N, Ream E, Young A, Richardson A (2009) Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol 27(36):6172–6179. doi:10.1200/JCO.2009.22.5151 PubMedCrossRef

50.

Mor V, Masterson-Allen S, Houts P, Siegel K (1992) The changing needs of patients with cancer at home. A longitudinal view. Cancer 69(3):829–838. doi:10.1002/1097-0142(19920201 PubMedCrossRef

51.

Garofalo JP, Choppala S, Hamann HA, Gjerde J (2009) Uncertainty during the transition from cancer patient to survivor. Cancer Nurs 32(4):E8–E14. doi:10.1097/NCC.1090b1013e31819f31811aab, 10.1097/NCC.0b013e31819f1aab PubMedCrossRef

52.

Sedgwick P (2011) Meta-analyses: funnel plots. BMJ 343. doi:10.1136/bmj.d5372

Title: The unfulfilled promise: a systematic review of interventions to reduce the unmet supportive care needs of cancer patients
Authors: Mariko Carey
Sylvie Lambert
Rochelle Smits
Chris Paul
Rob Sanson-Fisher
Tara Clinton-McHarg
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 2/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-011-1327-1

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2012

Managing chronic pain: results from an open-label study using MC5-A Calmare® device

The Beck Depression Inventory (BDI-II) and a single screening question as screening tools for depressive disorder in Dutch advanced cancer patients

Baseline depression predicts malnutrition in head and neck cancer patients undergoing radiotherapy

Perceptions about complementary and alternative medicine use among Chinese immigrant parents of children with cancer

Body mass index and annual increase of body mass index in long-term childhood cancer survivors; relationship to treatment

A bridge between cultures: interpreters’ perspectives of consultations with migrant oncology patients

Keynote webinar | Spotlight on antibody–drug conjugates in cancer