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JCO Early Release, published online ahead of print Nov 2 2009
Journal of Clinical Oncology, 10.1200/JCO.2009.22.5151

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Received February 23, 2009
Accepted August 11, 2009

Patients' Supportive Care Needs Beyond the End of Cancer Treatment: A Prospective, Longitudinal Survey

Jo Armes,* Maggie Crowe, Lynne Colbourne, Helen Morgan, Trevor Murrells, Catherine Oakley, Nigel Palmer, Emma Ream, Annie Young, and Alison Richardson

From the Florence Nightingale School of Nursing and Midwifery, King's College London; Cancer Services, Guy's and St Thomas' NHS Foundation Trust; National Cancer Research Institute, Psycho-Social Oncology Clinical Studies Group, London; Cancer Services, Royal United Hospital Bath National Health Service (NHS) Trust, Bath; Oncology Centre, Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire; Division of Specialised Services, University Hospitals Bristol NHS Foundation Trust, Bristol; and the 3 Counties Cancer Network, Cheltenham, United Kingdom.

* To whom correspondence should be addressed. E-mail: jo.armes{at}kcl.ac.uk

Purpose: To estimate prevalence and severity of patients' self-perceived supportive care needs in the immediate post-treatment phase and identify predictors of unmet need.

Patients and Methods: A multicenter, prospective, longitudinal survey was conducted. Sixty-six centers recruited patients for 12 weeks. Patients receiving treatment for the following cancers were recruited: breast, prostate, colorectal, and gynecologic cancer and non-Hodgkin's lymphoma. Measures of supportive care needs, anxiety and depression, fear of recurrence, and positive and negative affect were completed at the end of treatment (T0) and 6 months later (T1).

Results: Of 1,850 patients given questionnaire packs, 1,425 (79%) returned questionnaires at T0, and 1,152 (62%) returned questionnaires at T1. Mean age was 61 years; and most respondents were female (69%) and had breast cancer (57%). Most patients had no or few moderate or severe unmet supportive care needs. However, 30% reported more than five unmet needs at baseline, and for 60% of these patients, the situation did not improve. At both assessments, the most frequently endorsed unmet needs were psychological needs and fear of recurrence. Logistic regression revealed several statistically significant predictors of unmet need, including receipt of hormone treatment, negative affect, and experiencing an unrelated significant event between assessments.

Conclusion: Most patients do not express unmet needs for supportive care after treatment. Thirty percent reported more than five moderate or severe unmet needs at both assessments. Unmet needs were predicted by hormone treatment, negative mood, and experiencing a significant event. Our results suggest that there is a proportion of survivors with unmet needs who might benefit from the targeted application of psychosocial resources.


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Copyright © 2009 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
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