Supportive care needs among Indigenous cancer patients in Queensland, Australia: less comorbidity is associated with greater practical and cultural unmet need

Abstract

Little is known about the supportive care needs (SCN) of Australian Indigenous cancer patients. This cross-sectional study investigated the association between comorbidity and SCN among newly diagnosed Indigenous cancer patients in Queensland. Comorbidity was ascertained from medical chart review using the Charlson Comorbidity Index (CCI) and SCN were measured using the Supportive Care Needs Assessment Tool for Indigenous Peoples (SCNAT-IP). Of 183 participants, 76 (42%) had no comorbidity (CCI = 0), 60 (33%) had had a CCI score of 1 and 47 (26%) had a CCI of two or more, with the most common condition being diabetes (30%). The most common moderate-high unmet need items varied between comorbidity groups, although all patients most frequently reported moderate-high unmet need in the Physical and Psychological and the Practical and Cultural needs domains. Patients with the greatest comorbidity (CCI ≥ 2) had significantly more reduced odds of practical and cultural needs than patients without comorbidity (OR 0.28, 95% CI 0.11-0.75). This appeared to be partially explained by time since diagnosis, age, whether they were receiving current treatment and residential remoteness. Patients' experience of chronic disease, hospitals and the healthcare system may better prepare them for the practical and cultural aspects of their cancer journey.

Everyday Lives of Middle-Aged Persons with Multimorbidity: A Mixed Methods Systematic Review

“…The 13 qualitative studies [ 27 , 41 , 45 , 46 , 47 , 49 , 51 , 55 , 57 , 60 , 61 , 63 , 64 ] had a low RoB. The quality of the 30 quantitative studies [ 24 , 25 , 26 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 43 , 44 , 48 , 50 , 52 , 53 , 54 , 56 , 58 , 59 , 62 , 65 , 66 , 67 ] varied, with 26 studies [ 24 , 25 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 ,…”

“…Eighteen studies [ 25 , 26 , 27 , 31 , 33 , 41 , 43 , 45 , 47 , 48 , 51 , 52 , 54 , 55 , 59 , 63 , 65 , 67 ] explored psychosocial functioning in middle-aged persons with multimorbidity.…”

“…Diaz et al [ 31 ] used the Supportive Care Needs Assessment Tool for Indigenous People (SCNAT-IP) [ 74 ] to investigate the association between comorbidity and supportive care needs among indigenous people in Australia that had been newly diagnosed with cancer. The most commonly reported moderate–high unmet needs were in the psychological (i.e., anxiety, feeling down or sad) and the practical and cultural (i.e., money worries) domains.…”

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

“…A modified Charlson comorbidity index was calculated; patients were grouped as 0 (no comorbidity) with higher scores indicating higher comorbidity burden. 41,42 Information on communications to and from the PHC service about the patient that was related to their cancer (e.g. referrals, HDS), letters from specialists (e.g.…”

“…Internal Medicine Journal 50 (2020) [38][39][40][41][42][43][44][45][46][47] may require early post-discharge follow up in primary care. Incomplete or delayed access to information by GP has been linked to preventable medical errors.…”