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

Carey, Mariko; Lambert, Sylvie; Smits, Rochelle; Paul, Chris; Sanson‐Fisher, Rob; Clinton‐McHarg, Tara

doi:10.1007/s00520-011-1327-1

Cited by 140 publications

(128 citation statements)

References 46 publications

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“…Examples include symptom management, assistance with transportation, provision of health information, food preparation and other activities of daily living (adls), and psychological support and counselling services 11 . An unmet supportive care need can then be defined as "those needs which lack the level of service or support an individual perceives is necessary to achieve optimal well-being" 12 . Unmet supportive care needs can occur across the supportive care domains of information, symptom management, psychosocial support, and support for daily activities 12 .…”

Section: Introductionmentioning

confidence: 99%

“…An unmet supportive care need can then be defined as "those needs which lack the level of service or support an individual perceives is necessary to achieve optimal well-being" 12 . Unmet supportive care needs can occur across the supportive care domains of information, symptom management, psychosocial support, and support for daily activities 12 .…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence and Nature of Supportive Care Needs in Lung Cancer Patients

et al. 2016

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PurposeIn the present work, we set out to comprehensively describe the unmet supportive care and information needs of lung cancer patients. MethodsThis cross-sectional study used the Supportive Care Needs Survey Short Form 34 (34 items) and an informational needs survey (8 items). Patients with primary lung cancer in any phase of survivorship were included. Demographic data and treatment details were collected from the medical charts of participants. The unmet needs were determined overall and by domain. Univariable and multivariable regression analyses were performed to determine factors associated with greater unmet needs. were recruited. The mean number of unmet needs was 8 (range: 0-34), and 69 patients (78%) reported at least 1 unmet need. The need proportions by domain were 52% health system and information, 66% psychological, 58% physical, 24% patient care, and 20% sexuality. The top 2 unmet needs were "fears of the cancer spreading" [n = 44 of 84 (52%)] and "lack of energy/tiredness" [n = 42 of 88 (48%)]. On multivariable analysis, more advanced disease and higher MD Anderson Symptom Inventory scores were associated with increased unmet needs. Patients reported that the most desired information needs were those for information on managing symptoms such as fatigue (78%), shortness of breath (77%), and cough (63%). ResultsConclusions Unmet supportive care needs are common in lung cancer patients, with some patients experiencing a very high number of unmet needs. Further work is needed to develop resources to address those needs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Prevalence and Nature of Supportive Care Needs in Lung Cancer Patients

et al. 2016

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“…Cancer has been associated with patient uncertainty and need for reassurance. 8 Patient feedback suggested that the intervention, delivered by oncology team NPs, provided this type of support. This finding also may reflect that certain symptoms are less responsive to available treatments.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Timely symptom management is critical to improving patient outcomes. 8 Earlier studies have proposed telephone follow-up as a key approach to enhance outpatient cancer care. 9 More recently, several randomized controlled trials tested nursing interventions to reduce symptoms and improve QOL in patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

Nursing intervention to enhance outpatient chemotherapy symptom management: Patient‐reported outcomes of a randomized controlled trial

Traeger

McDonnell

McCarty

et al. 2015

Cancer

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BACKGROUND:The authors conducted a randomized controlled trial to evaluate a nurse practitioner (NP)-delivered symptom management intervention for patients initiating chemotherapy for nonmetastatic cancer. The aim was to reduce patient-reported symptom burden by facilitating patient-NP collaboration and the early management of symptoms. METHODS: At the time of the first chemotherapy visit, adult participants with nonmetastatic breast, colorectal, or lung cancer (120 participants) completed self-report measures and were then randomly assigned to standard care plus the intervention or standard care alone. Intervention participants received proactive telephone calls from their oncology team NP during the week after each of the first 2 chemotherapy administration visits. Measures were repeated at the second and third chemotherapy visits. Group differences were analyzed with regard to patient-reported symptoms (Memorial Symptom Assessment Scale-Short Form items), satisfaction with care (Family Caregiver Satisfaction-patient scale), and the likelihood of depression or anxiety symptoms (Patient Health Questionnaire-4). RESULTS: At the time of the first visit, 50.8% of participants reported 1 physical symptom, most commonly lack of energy (35.8%) and drowsiness (30.8%). The number of symptoms (gamma coefficient [g] 5 0.16; P<.001), symptom distress (g 5 0.45; P<.001), and satisfaction with care (g 5 0.24; P 5 .004) increased whereas the likelihood of anxiety symptoms decreased (g 5 -0.19; P 5 .02) and the likelihood of depression symptoms did not change (g 5 0.01; P 5 .91). Outcomes did not differ by randomized group. Randomized group interacted with emetogenic potential in predicting symptom distress (c 5 0.43; P 5 .03) and satisfaction with care (c 5 -0.45; P 5 .045). CONCLUSIONS: The intervention did not appear to reduce symptom burden compared with standard care. Early symptoms highlight the importance of continuing to examine strategies to improve symptom management during chemotherapy for nonmetastatic disease. Cancer 2015;121:3905-13.

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“…Encouraging data have been published from cancer patients in general showing that adequate interventions are able to reduce the needs and subsequent depression [73,74]. However, a systematic Cochrane review by RUEDA et al [75] assessing the impact of noninvasive interventions on quality of life and psychological functioning specifically in lung cancer patients was only able to detect 15 smaller, heterogeneous trials.…”

Section: Psychological Dimensionmentioning

confidence: 99%

The lung cancer patient, the pneumologist and palliative care: a developing alliance

Blum

Schönfeld

2014

Eur Respir J

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Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists' attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation. @ERSpublications Pneumologists should get more widely involved in palliative care for lung cancer patients

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

Cited by 140 publications

References 46 publications

The Prevalence and Nature of Supportive Care Needs in Lung Cancer Patients

The Prevalence and Nature of Supportive Care Needs in Lung Cancer Patients

Nursing intervention to enhance outpatient chemotherapy symptom management: Patient‐reported outcomes of a randomized controlled trial

The lung cancer patient, the pneumologist and palliative care: a developing alliance

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