What are the unmet supportive care needs of people with cancer? A systematic review
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Goals of work
The identification and management of unmet supportive care needs is an essential component of health care for people with cancer. Information about the prevalence of unmet need can inform service planning/redesign.
Materials and methods
A systematic review of electronic databases was conducted to determine the prevalence of unmet supportive care needs at difference time points of the cancer experience.
Of 94 articles or reports identified, 57 quantified the prevalence of unmet need. Prevalence of unmet need, their trends and predictors were highly variable in all domains at all time points. The most frequently reported unmet needs were those in the activities of daily living domain (1–73%), followed by psychological (12–85%), information (6–93%), psychosocial (1–89%) and physical (7–89%). Needs within the spiritual (14–51%), communication (2–57%) and sexuality (33–63%) domains were least frequently investigated. Unmet needs appear to be highest and most varied during treatment, however a greater number of individuals were likely to express unmet need post-treatment compared to any other time. Tumour-specific unmet needs were difficult to distinguish. Variations in the classification of unmet need, differences in reporting methods and the diverse samples from which patients were drawn inhibit comparisons of studies.
The diversity of methods used in studies hinders analysis of patterns and predictors of unmet need among people with cancer and precludes generalisation. Well-designed, context-specific, prospective studies, using validated instruments and standard methods of analysis and reporting, are needed to benefit future interventional research to identify how best to address the unmet supportive care needs of people with cancer.
KeywordsSupportive care needs Unmet need Patient-centred care Systematic review
- 1.American Cancer Society (1979) Report on the social economic and psychological needs of cancer patients in California. Greenleigh Associates, San Francisco, CAGoogle Scholar
- 8.Bourgeois-Law G, Lotocki R (1999) Sexuality and gynaecological cancer: A needs assessment. Can J Hum Sex 8:231–240Google Scholar
- 9.Bullard DG, Causey GG, Newman AB, Orloff R, Schanche K, Wallace DH (1980) Sexual health care and cancer: a needs assessment. Front Radiat Ther Oncol 14:55–58Google Scholar
- 11.Canadian Cancer Society (1992) Final report on the needs of people living with cancer across Canada. Canadian Cancer Society, OntarioGoogle Scholar
- 19.Department of Health (2000) The NHS Cancer Plan. Department of Health, LondonGoogle Scholar
- 20.Duke J, Byles J, Treloar C (2001) The perceived needs of men diagnosed with prostate cancer. Australasian Epidemiologist 8:34–40Google Scholar
- 21.Epstein RM, Street RL Jr (2007) Patient-centred communication in cancer care: promoting healing and reducing suffering. National Cancer Institute, NIH Publication No. 07-6225, Bethesda, MDGoogle Scholar
- 22.Foot G, Sanson-Fisher R (1995) Measuring the unmet needs of people living with cancer. Cancer Forum 19:131–135Google Scholar
- 28.Gustafson DH (2005) Needs assessment in cancer. In: Lipscomb J, Gotay CC, Snyder C (eds) Outcomes assessment in cancer: Measures methods and applications. Cambridge University Press, Cambridge, pp 305–328Google Scholar
- 29.Gysels M, Higginson IJ, Rajasekaran M, Davies E, Harding R (2004) Improving supportive and palliative care for adults with cancer: Research Evidence. National Institute of Clinical Excellence & Kings College London, LondonGoogle Scholar
- 36.Institute of Medicine (2008) Cancer care for the whole patient: meeting psychosocial concerns. The National Academic Press, Washington DCGoogle Scholar
- 37.Institute of Medicine (2001) Crossing the quality chasm: A new health system for the 21st century. National Academy Press, Washington DCGoogle Scholar
- 44.McElduff P, Boyes A, Zucca A, Girgis A (2004) The Supportive Care Needs Survey: a guide to administration scoring and analysis. Centre for Health Research & Psycho-oncology, NewcastleGoogle Scholar
- 50.National Health Priority Action Council (NHPAC) (2006) National Service Improvement Framework for Cancer. Australian Government Department of Health and Ageing, CanberraGoogle Scholar
- 66.Sullivan T, Weinert C, Fulton RD (1993) Living with cancer: Self-identified needs of rural dwellers. Community Health 16:41–49Google Scholar
- 67.Sutherland G, Morland M, Hill D, Pruden M, McLachlan S (2004) The supportive care needs of newly diagnosed patients with cancer: A pilot study. The Cancer Council Victoria, MelbourneGoogle Scholar
- 72.Thomas C, Morris SM, McMllmurray MB, Soothill K, Francis B, Harman JC (2001) The psychosocial needs of cancer patients and their main carers. Institute for Health Research, Lancaster University, LancasterGoogle Scholar