Improving Outcomes for People With Progressive Cancer: Interrupted Time Series Trial of a Needs Assessment Intervention
Open accessAbstract
Context Improving the effectiveness of cancer care delivery has become a major focus of research.Objectives This study assessed the uptake and impact of the Palliative Care Needs Assessment Guidelines and Needs Assessment Tool: Progressive Disease--Cancer (NAT: PD-C) on the outcomes of people with advanced cancer.Methods Given widely varying survival in people with advanced cancer, an interrupted time series design was used, with data on unmet needs, depression, anxiety, and quality of life collected from 195 patients using telephone interviews every two months, for up to 18 months. Patients completed at least two baseline interviews before health professionals were academically detailed in the use of the Palliative Care Needs Assessment Guidelines and NAT: PD-C. Health professionals completed the NAT: PD-C with patients approximately monthly for the remainder of the study. Changes in patients' outcomes were compared prior to and following the introduction of the NAT: PD-C using general estimating equations.Results Moderate to high needs across all domains were frequently seen in the preintervention phase. The use of the NAT: PD-C was associated with a significant reduction in health system and information and patient care and support needs.Conclusion These resources have the potential as an efficient and acceptable strategy for supporting needs-based cancer care. Further work is required to determine their unique contribution to improvements in patient outcomes.
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Care recipients with a mental illness or advanced or palliative disease have different needs, and in advanced disease grief and bereavement play a role.
“Care recipients with a mental illness (e.g., schizophrenia) or advanced or palliative disease were excluded as the needs of these groups differ and in the case of advanced disease grief and bereavement play a role.[21][22][23]”
From Non-pharmacological Interventions for Caregivers with Depression and Caregivers of Care Recipients with Co-morbid Depression: Systematic Review and Meta-analysis (2021) · cites this paper as [23]
The Introduction (page unavailable) says people with advanced cancer often have greater unmet needs than those with localized disease, and the Materials section includes caregiver bereavement issues in its needs-assessment tool. The paper does not establish that care recipients with mental illness, such as schizophrenia, have different needs, or give these needs as a reason to exclude either group. (LLM, conf=0.87)
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References 36 · Cited by 59
Research works printed but not linked: 5
- Sanson-Fisher RW, Girgis A, Boyes A, et al. The unmet supportive care needs of patients with cancer. Cancer 2000;88:226e237.
- England E. How interrupted time series analysis can evaluate guidelines implementation. Pharm J 2005;275:344e347.
- Bonevski B, Sanson-Fisher R, Girgis A, et al. Evaluation of an instrument to assess the needs of patients with cancer. Supportive Care Review Group. Cancer 2000;88:217e225.
- Addington-Hall J, MacDonald LD, Anderson HR, et al. Randomised control trial of effects of coordinat- ing care for terminal ill cancer patients. Br Med J 1992;305:1317e1322.
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- Authors
- Waller, A., Girgis, A., Johnson, C., Lecathelinais, C., Sibbritt, D., Forstner, D., Liauw, W., & Currow, D. C.
- Affiliations
- Hunter Medical Research Institute (AU)
- University of Newcastle Australia (AU)
- Liverpool Hospital (AU)
- St George Hospital (AU)
- Flinders University (AU)
- Corresponding author
- Waller, Amy
- ORCID
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 43
- Issue
- 3
- Pages
- 569-581
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2051541055
- Cited by
- 59
- References
- 36
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 7 · 2021: 11 · 2020: 3 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 3 · 2012: 3
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Figshare (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- Australian Government
- Hunter Medical Research Institute
- Medical Research Council
- National Health and Medical Research Council
- Cancer Council NSW
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- palliative care needs assessment, needs assessment tool, advanced cancer, unmet needs, health professions education, depression, anxiety, quality of life, health system needs, information needs
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety, Data Interpretation, Statistical, Depression, Female, Humans, Infant, Male, Middle Aged, Neoplasms, Palliative Care, Quality of Life, Socioeconomic Factors, Treatment Outcome, Guidelines as Topic, Sample Size, Disease Progression, Needs Assessment, Young Adult, Quality Improvement
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