Melissa B Mazor1, Lihua Li2, Jose Morillo3, Olivia S Allen4, Juan P Wisnivesky3, Cardinale B Smith5. 1. Division of General Internal Medicine (M.B.M., J.M., J.P.W.), Icahn School of Medicine at Mount Sinai, New York, New York, USA. Electronic address: Melissa.mazor@mountsinai.org. 2. Brookdale Department of Geriatrics and Palliative Medicine (L.L., C.B.S.), Icahn School of Medicine at Mount Sinai, New York, New York, USA. 3. Division of General Internal Medicine (M.B.M., J.M., J.P.W.), Icahn School of Medicine at Mount Sinai, New York, New York, USA. 4. Division of Hematology/Medical Oncology (O.S.A., C.B.S.), Icahn School of Medicine at Mount Sinai, New York, New York, USA. 5. Brookdale Department of Geriatrics and Palliative Medicine (L.L., C.B.S.), Icahn School of Medicine at Mount Sinai, New York, New York, USA; Division of Hematology/Medical Oncology (O.S.A., C.B.S.), Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
CONTEXT: Little is known about inequities in supportive care needs among diverse patients with advanced lung cancer. OBJECTIVES: We aimed to examine differences in supportive care needs between racial/ethnic minority and non-minority patients with lung cancer and identify how these needs change over time. METHODS: We performed a prospective cohort study of patients newly diagnosed with advanced lung cancer (stage III and IV). Patients completed a validated survey at baseline, 4-, 8- and 12-months post-diagnosis, assessing supportive care needs: medical communication/information, psychological/emotional support, daily living, financial concerns, physical symptoms, and spiritual and social needs. Univariable and multivariable regression analyses compared differences in supportive care needs between minority (Black and Latinx) and non-minority patients. A mixed effect model with minority status, follow-up time and the interaction between minority status and time assessed the association between each need and minority status with changes over time. RESULTS: We enrolled 99 patients; 55 (56%) were minorities and 44 (44%) were non-minorities. At baseline, minorities reported significantly higher needs across each domain except medical communication/information. Over time, these reported differences remained consistent except for medical communication. After adjustment, the needs of both minorities and non-minorities increased significantly in the psychological/emotional, daily living and physical symptom domains. CONCLUSION: Minority patients with advanced lung cancer are more likely to have higher baseline and persistent supportive care needs relatives to non-minority patients. Clinicians caring for minority patients with lung cancer should provide targeted supportive care evaluation and treatment to ensure health equity.
CONTEXT: Little is known about inequities in supportive care needs among diverse patients with advanced lung cancer. OBJECTIVES: We aimed to examine differences in supportive care needs between racial/ethnic minority and non-minority patients with lung cancer and identify how these needs change over time. METHODS: We performed a prospective cohort study of patients newly diagnosed with advanced lung cancer (stage III and IV). Patients completed a validated survey at baseline, 4-, 8- and 12-months post-diagnosis, assessing supportive care needs: medical communication/information, psychological/emotional support, daily living, financial concerns, physical symptoms, and spiritual and social needs. Univariable and multivariable regression analyses compared differences in supportive care needs between minority (Black and Latinx) and non-minority patients. A mixed effect model with minority status, follow-up time and the interaction between minority status and time assessed the association between each need and minority status with changes over time. RESULTS: We enrolled 99 patients; 55 (56%) were minorities and 44 (44%) were non-minorities. At baseline, minorities reported significantly higher needs across each domain except medical communication/information. Over time, these reported differences remained consistent except for medical communication. After adjustment, the needs of both minorities and non-minorities increased significantly in the psychological/emotional, daily living and physical symptom domains. CONCLUSION: Minority patients with advanced lung cancer are more likely to have higher baseline and persistent supportive care needs relatives to non-minority patients. Clinicians caring for minority patients with lung cancer should provide targeted supportive care evaluation and treatment to ensure health equity.
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