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Supportive Care in Cancer
Published in: Supportive Care in Cancer 8/2016

01-08-2016 | Review Article

Unmet care needs in people living with advanced cancer: a systematic review

Authors: Nima Moghaddam, Helen Coxon, Sally Nabarro, Beth Hardy, Karen Cox

Published in: Supportive Care in Cancer | Issue 8/2016

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Abstract

Purpose

The support needs of cancer patients vary according to the phase of their cancer journey. Recent developments in healthcare are such that the advanced cancer phase is increasingly experienced as a chronic illness phase, with consequent changes in patient support needs. Understanding these needs, and identifying areas of unmet need, can enable us to develop services that are more adequate to the task of supporting this population.

Methods

We conducted a systematic search of four electronic databases to identify studies examining the unmet needs of people living with advanced cancer. Relevant data were extracted and synthesised; meta-analyses were conducted to obtain pooled estimates for prevalence of needs.

Results

We identified 23 studies (4 qualitative) for inclusion. Unmet needs were identified across a broad range of domains, with greatest prevalence in informational (30–55 %), psychological (18–42 %), physical (17–48 %), and functional (17–37 %) domains. There was considerable heterogeneity amongst studies in terms of methods of assessment, coding and reporting of needs, respondent characteristics, and appraised study quality.

Conclusions

Heterogeneity made it difficult to compare across studies and inflated confidence intervals for pooled estimates of prevalence—we need standardised and comprehensive approaches to assessment and reporting of unmet needs to further our understanding. Nonetheless, the review identified prominent needs across a range of (interacting) experiential domains. Moreover, by focussing on unmet needs for support, we were able to extrapolate potential implications for service development.
Footnotes
1
In order to capture everyday needs of people living with advanced disease, we focussed on the chronic phase: i.e. we excluded patients considered to be at the end-stage of cancer (following the definition of chronic advanced cancer by Harley et al. [11]) or reporting acute needs at points of inpatient admission. Although increasingly experienced and recognised [11] we found (in initial scoping searches) that few studies used consistent terms or definitions to describe the pre-end-stage phase of advanced cancer; consequently, we used a broadly sensitive search but then applied exclusion criteria to enable sufficient specificity.
 
2
Eight of the quantitative studies primarily assessed needs in a single domain and were not included in the meta-analysis (which was restricted to studies applying multidimensional needs assessments).
 
Literature
1.
McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers S (2010) Predictors of change in unmet supportive care needs in cancer. Psycho-Oncology 19:508–516CrossRefPubMed
2.
Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17:1117–1128CrossRefPubMed
3.
4.
Snyder CF, Dy SM, Hendricks DE, Brahmer JR, Carducci MA, Wolff AC, Wu AW (2007) Asking the right questions: investigating needs assessments and health-related quality-of-life questionnaires for use in oncology clinical practice. Support Care Cancer 15:1075–1085CrossRefPubMed
5.
Valery PC, Powell E, Moses N, Volk ML, McPhail SM, Clark PJ, Martin J (2015) Systematic review: unmet supportive care needs in people diagnosed with chronic liver disease. BMJ open 5:e007451CrossRefPubMedPubMedCentral
6.
Lam WW, Au AH, Wong JH, Lehmann C, Koch U, Fielding R, Mehnert A (2011) Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat 130:531–541CrossRefPubMed
7.
Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88:226–237CrossRefPubMed
8.
Waller A, Girgis A, Johnson C, Lecathelinais C, Sibbritt D, Forstner D, Liauw W, Currow DC (2012) Improving outcomes for people with progressive cancer: interrupted time series trial of a needs assessment intervention. J Pain Symptom Manag 43:569–581CrossRef
9.
10.
Thorne SE, Oliffe JL, Oglov V, Gelmon K (2013) Communication challenges for chronic metastatic cancer in an era of novel therapeutics. Qual Health Res 23:863–875CrossRefPubMed
11.
Harley C, Pini S, Bartlett YK, Velikova G (2012) Defining chronic cancer: patient experiences and self-management needs. BMJ Support Palliat Care 2:248–255CrossRefPubMed
12.
Coulter A, Roberts S, Dixon A (2013) Delivering better services for people with long-term conditions: building the house of care. The King’s Fund, London
13.
Wagner E (1998) Chronic disease management: what will it take to improve care for chronic illness? ECP 1:2PubMed
14.
Puts M, Papoutsis A, Springall E, Tourangeau A (2012) A systematic review of unmet needs of newly diagnosed older cancer patients undergoing active cancer treatment. Support Care Cancer 20:1377–1394CrossRefPubMed
15.
Snilstveit B, Oliver S, Vojtkova M (2012) Narrative approaches to systematic review and synthesis of evidence for international development policy and practice. J Dev Effect 4:409–429CrossRef
16.
Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269CrossRefPubMed
17.
Pluye P, Robert E, Cargo M, Bartlett G, O’Cathain A, Griffiths F, Boardman F, Gagnon M, Rousseau M (2011) Proposal: A mixed methods appraisal tool for systematic mixed studies reviews. McGill University, Montréal, pp. 1–8
18.
Souto RQ, Khanassov V, Hong QN, Bush PL, Vedel I, Pluye P (2015) Systematic mixed studies reviews: updating results on the reliability and efficiency of the mixed methods appraisal tool. Int J Nurs Stud 1:500–501CrossRef
19.
Anderson H, Ward C, Eardley A, Gomm S, Connolly M, Coppinger T, Corgie D, Williams J, Makin WP (2001) The concerns of patients under palliative care and a heart failure clinic are not being met. Palliat Med 15:279–286CrossRefPubMed
20.
Aranda S, Schofield P, Weih L, Yates P, Milne D, Faulkner R, Voudouris N (2005) Mapping the quality of life and unmet needs of urban women with metastatic breast cancer. Eur J cancer care 14:211–222CrossRef
21.
Au A, Lam W, Tsang J, Tk Y, Soong I, Yeo W, Suen J, Ho WM, Ky W, Kwong A (2013) Supportive care needs in Hong Kong Chinese women confronting advanced breast cancer. Psycho-Oncology 22:1144–1151CrossRefPubMed
22.
Beesley VL, Price MA, Webb PM, O’Rourke P, Marquart L, Butow PN (2013) Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs. Psycho-Oncology 22:1565–1571CrossRefPubMed
23.
Carter N, Bryant-Lukosius D, DiCenso A, Blythe J, Neville AJ (2011) The supportive care needs of men with advanced prostate cancer. Oncol Nurs Forum 38:189–198
24.
25.
Dale J, Jatsch W, Hughes N, Pearce A, Meystre C (2004) Information needs and prostate cancer: the development of a systematic means of identification. BJU Int 94:63–69CrossRefPubMed
26.
Fitch MI (2012) Supportive care needs of patients with advanced disease undergoing radiotherapy for symptom control. Can Oncol Nurs J /Revue canadienne de soins infirmiers en Oncologie 22:84–91CrossRef
27.
Hwang SS, Chang VT, Cogswell J, Alejandro Y, Osenenko P, Morales E, Srinivas S, Kasimis B (2004) Study of unmet needs in symptomatic veterans with advanced cancer: incidence, independent predictors and unmet needs outcome model. J Pain Symptom Manag 28:421–432CrossRef
28.
Mor V, Guadagnoli E, Wool MS (1987) An examination of the concrete service needs of advanced cancer patients. J Psychosoc Oncol 5:1–17CrossRef
29.
Mor V, Masterson-Allen S, Houts P, Siegel K (1992) The changing needs of patients with cancer at home. A longitudinal view. Cancer 69:829–838CrossRefPubMed
30.
Murray SA, Kendall M, Boyd K, Worth A, Benton TF (2004) Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliat Med 18:39–45CrossRefPubMed
31.
Osse BH, Vernooij-Dassen MJ, Schadé E, Grol RP (2005) The problems experienced by patients with cancer and their needs for palliative care. Support Care Cancer 13:722–732CrossRefPubMed
32.
Passalacqua S, Di Rocco ZC, Di Pietro C, Mozzetta A, Tabolli S, Scoppola A, Marchetti P, Abeni D (2012) Information needs of patients with melanoma: a nursing challenge. Clin J Oncol Nurs 16:625–632CrossRefPubMed
33.
Siegel K, Mesagno FP, Karus DG, Christ G (1992) Reducing the prevalence of unmet needs for concrete services of patients with cancer. Evaluation of a computerized telephone outreach system. Cancer 69:1873–1883PubMed
34.
Soelver L, Rydahl-Hansen S, Oestergaard B, Wagner L (2014) Identifying factors significant to continuity in basic palliative hospital care—from the perspective of patients with advanced cancer. J Psychosoc Oncol 32:167–188CrossRefPubMed
35.
Templeton H, Coates V (2003) Informational needs of men with prostate cancer on hormonal manipulation therapy. Patient Educ Couns 49:243–256CrossRefPubMed
36.
Tomlinson K, Barker S, Soden K (2012) What are cancer patients’ experiences and preferences for the provision of written information in the palliative care setting? A focus group study. Palliat Med 26:760–765CrossRefPubMed
37.
Uchida M, Akechi T, Okuyama T, Sagawa R, Nakaguchi T, Endo C, Yamashita H, Toyama T, Furukawa TA (2010) Patients’ supportive care needs and psychological distress in advanced breast cancer patients in Japan. Jpn J Clin Oncol: hyq230
38.
Voogt E, van Leeuwen AF, Visser AP, van der Heide A, van der Maas PJ (2005) Information needs of patients with incurable cancer. Support Care Cancer 13:943–948CrossRefPubMed
39.
Wong RK, Franssen E, Szumacher E, Connolly R, Evans M, Page B, Chow E, Hayter C, Harth T, Andersson L (2002) What do patients living with advanced cancer and their carers want to know?—a needs assessment. Support Care Cancer 10:408–415CrossRefPubMed
40.
Montero-Marin J, Prado-Abril J, Demarzo M, Gascon S, Garcıa-Campayo J (2014) Coping with stress and types of burnout: explanatory power of different coping strategies. PLoS One 9:e89090CrossRefPubMedPubMedCentral
41.
Bensing JM, Hulsman RL, Schreurs KM (1999) Gender differences in fatigue: biopsychosocial factors relating to fatigue in men and women. Med Care 37:1078–1083CrossRefPubMed
42.
Adler NE, Page AE (2008) Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. National Academies Press, Washington DC
43.
Fielding R, Lam WWT, Shun SC, Okuyama T, Lai YH, Wada M, Akechi T, Li WWY (2013) Attributing variance in supportive care needs during cancer: culture-service, and individual differences, before clinical factors. PLoS One 8:e65099CrossRefPubMedPubMedCentral
44.
Compas BE, Jaser SS, Dunn MJ, Rodriguez EM (2012) Coping with chronic illness in childhood and adolescence. Annu Rev Clin Psychol 8:455CrossRefPubMed
45.
Carey M, Lambert S, Smits R, Paul C, Sanson-Fisher R, Clinton-McHarg T (2012) The unfulfilled promise: a systematic review of interventions to reduce the unmet supportive care needs of cancer patients. Support Care Cancer 20:207–219CrossRefPubMed
Metadata
Title
Unmet care needs in people living with advanced cancer: a systematic review
Authors
Nima Moghaddam
Helen Coxon
Sally Nabarro
Beth Hardy
Karen Cox
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 8/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3221-3

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