Unmet care needs in people living with advanced cancer: a systematic review
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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.
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.
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.
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.
KeywordsUnmet needs Advanced cancer Supportive care Systematic review
Compliance with ethical standards
This work was supported by Research Capability Funding from the National Institute of Health Research, awarded via CityCare.
Conflict of interest
The authors declare that they have no competing interests. None of the authors has a financial relationship with any organisation for which this research would present a conflict of interest. The data were in the hands of the authors at all times and are available to the journal upon request.
- 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, LondonGoogle Scholar
- 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. 1–8Google Scholar
- 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 38:189–198Google Scholar
- 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: hyq230Google Scholar
- 42.Adler NE, Page AE (2008) Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. National Academies Press, Washington DCGoogle Scholar