A Molassiotis1, P Yates2, Q Li3, W K W So4, K Pongthavornkamol5, P Pittayapan6, H Komatsu7, M Thandar8, M Yi9, S Titus Chacko10, V Lopez11, J Butcon12, D Wyld13, R J Chan2. 1. School of Nursing, Hong Kong Polytechnic University, Hong Kong. Electronic address: alex.molasiotis@polyu.edu.hk. 2. School of Nursing, Queensland University of Technology, Brisbane; Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane; Cancer Nursing Professorial Precinct, Royal Brisbane and Women's Hospital, Brisbane, Australia. 3. Wuxi School of Medicine, Jiangnan University, Wuxi, China. 4. Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong. 5. Faculty of Nursing, Mahidol University, Bangkok. 6. Nursing Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 7. Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan. 8. University of Nursing, Yangon, Myanmar. 9. College of Nursing, Seoul National University, Seoul, Republic of Korea. 10. College of Nursing, Christian Medical College, Vellore, India. 11. Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore. 12. School of Nursing, Hong Kong Polytechnic University, Hong Kong; College of Medicine, Bicol University, Philippines. 13. Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane; School of Medicine, University of Queensland, Brisbane, Australia.
Abstract
Background: To assess the supportive care needs, quality of life (QoL) and symptoms of patients with cancer after the end of first-line treatments and into survivorship in Asian countries using Australian data as benchmark. Patients and methods: A cross-sectional survey was carried out in Australia and eight high-income (HICs) and low-/middle-income (LMICs) Asian countries (China, Japan, Hong Kong SAR, South Korea, Myanmar, Thailand, India, Philippines) using validated scales (Cancer Survivors Unmet Needs scale), physical-symptom concerns (Cancer Survivors Survey of Needs subscale) and a single-item measure of global QoL perception. Results: Data were collected from 1873 patients. QoL was highest in Australia and all other countries had significantly lower QoL than Australia (all P < 0.001). One-quarter of the patients reported low QoL (scores 1-3/10). The most frequently reported symptoms were fatigue (66.6%), loss of strength (61.8%), pain (61.6%), sleep disturbance (60.1%), and weight changes (57.7%), with no difference in symptom experience between Australian data and all other countries, or between HICs and LMICs. Unmet needs of moderate/strong level were particularly high in all aspects assessed, particularly in the area of existential survivorship (psychosocial care) and receiving comprehensive cancer care. Australia and HICs were similar in terms of unmet needs (all low), but LMICs had a significantly higher number of needs both compared with Australia and HICs (all P < 0.001). Conclusion: Health care systems in Asian countries need to re-think and prioritize survivorship cancer care and put action plans in place to overcome some of the challenges surrounding the delivery of optimal supportive cancer care, use available resource-stratified guidelines for supportive care and test efficient and cost-effective models of survivorship care.
Background: To assess the supportive care needs, quality of life (QoL) and symptoms of patients with cancer after the end of first-line treatments and into survivorship in Asian countries using Australian data as benchmark. Patients and methods: A cross-sectional survey was carried out in Australia and eight high-income (HICs) and low-/middle-income (LMICs) Asian countries (China, Japan, Hong Kong SAR, South Korea, Myanmar, Thailand, India, Philippines) using validated scales (Cancer Survivors Unmet Needs scale), physical-symptom concerns (Cancer Survivors Survey of Needs subscale) and a single-item measure of global QoL perception. Results: Data were collected from 1873 patients. QoL was highest in Australia and all other countries had significantly lower QoL than Australia (all P < 0.001). One-quarter of the patients reported low QoL (scores 1-3/10). The most frequently reported symptoms were fatigue (66.6%), loss of strength (61.8%), pain (61.6%), sleep disturbance (60.1%), and weight changes (57.7%), with no difference in symptom experience between Australian data and all other countries, or between HICs and LMICs. Unmet needs of moderate/strong level were particularly high in all aspects assessed, particularly in the area of existential survivorship (psychosocial care) and receiving comprehensive cancer care. Australia and HICs were similar in terms of unmet needs (all low), but LMICs had a significantly higher number of needs both compared with Australia and HICs (all P < 0.001). Conclusion: Health care systems in Asian countries need to re-think and prioritize survivorship cancer care and put action plans in place to overcome some of the challenges surrounding the delivery of optimal supportive cancer care, use available resource-stratified guidelines for supportive care and test efficient and cost-effective models of survivorship care.
Authors: Emily S Tonorezos; Dana Barnea; Richard J Cohn; Monica S Cypriano; Brice C Fresneau; Riccardo Haupt; Lars Hjorth; Yasushi Ishida; Jarmila Kruseova; Claudia E Kuehni; Purna A Kurkure; Thorsten Langer; Paul C Nathan; Jane E Skeen; Roderick Skinner; Nurdan Tacyildiz; Marry M van den Heuvel-Eibrink; Jeanette F Winther; Melissa M Hudson; Kevin C Oeffinger Journal: J Clin Oncol Date: 2018-06-06 Impact factor: 44.544