Levels of Symptom Burden During Chemotherapy for Advanced Lung Cancer: Differences Between Public Hospitals and a Tertiary Cancer Center
| Autor: | Arlene Nazario, Tito R. Mendoza, Guadalupe R. Palos, Garrett R. Lynch, Xin Shelley Wang, Jeanie F. Woodruff, Gary M. Mobley, Charles Lu, Kai Ping Liao, Charles S. Cleeland, Stephen P. Richman |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Lung Neoplasms Time Factors Medically Underserved Area Antineoplastic Agents Disease Risk Assessment Severity of Illness Index Health Services Accessibility Cost of Illness Quality of life Risk Factors Carcinoma Non-Small-Cell Lung Surveys and Questionnaires Internal medicine Original Reports Severity of illness Odds Ratio Humans Medicine Longitudinal Studies Prospective Studies Healthcare Disparities Propensity Score Prospective cohort study Lung cancer Aged Academic Medical Centers Performance status Hospitals Public business.industry Cancer Odds ratio Middle Aged medicine.disease United States Surgery Logistic Models Treatment Outcome Oncology Quality of Life Female business |
| Zdroj: | Journal of Clinical Oncology. 29:2859-2865 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose We compared risk factors for high disease- and treatment-related symptom burden over 15 weeks of therapy in medically underserved patients with advanced non–small-cell lung cancer and in patients treated at a tertiary cancer center. Patients and Methods We monitored symptom severity weekly during chemotherapy. Patients were recruited from a tertiary cancer center (n=101) and three public hospitals treating the medically underserved (n=80). We used a composite symptom-severity score and group-based trajectory analysis to form two groups: one with consistently more severe symptoms and another with less severe symptoms. We examined predictors of group membership. Results Seventy percent of the sample (n=126) reported low symptom-severity levels that decreased during therapy; 30% (n=55) had consistently severe symptoms throughout the study. In multivariate analysis, patients with good performance status being treated in public hospitals were significantly more likely than patients treated at the tertiary cancer center to be in the high-symptom group (odds ratio, 5.6; 95% CI, 2.1 to 14.6; P =.001) and to report significantly higher symptom interference (P =.001). Other univariate predictors of high-symptom group membership included variables associated with being medically underserved (eg, having less education, being single, and being nonwhite). No group differences by ethnicity were observed in the public hospitals. Medically underserved patients were less likely to receive adequate pain management. Conclusion Patients with advanced lung cancer and good performance status treated at public hospitals were more likely than those treated at a tertiary cancer center to experience substantial symptoms during chemotherapy. |
| Databáze: | OpenAIRE |
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