Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis: An Exploratory Study.
Indigenous Australians
chronic liver disease
patient reported outcomes
perceived needs
unmet needs
Journal
Patient preference and adherence
ISSN: 1177-889X
Titre abrégé: Patient Prefer Adherence
Pays: New Zealand
ID NLM: 101475748
Informations de publication
Date de publication:
2021
2021
Historique:
received:
04
10
2021
accepted:
09
11
2021
entrez:
2
12
2021
pubmed:
3
12
2021
medline:
3
12
2021
Statut:
epublish
Résumé
Understanding and responding to the supportive care needs of people with cirrhosis is essential to quality care. Indigenous Australians, Aboriginal and Torres Strait Islander people, are overrepresented amongst patients with cirrhosis. This study documented the nature and extent of supportive care needs of Indigenous Australians with cirrhosis, in comparison with non-Indigenous Australians. The supportive care needs of adult patients diagnosed with cirrhosis attending public hospitals in Queensland were assessed through the Supportive Needs Assessment tool for Cirrhosis (SNAC). Patients indicated how much additional help they needed on four subscales: 1. psychosocial issues; 2. practical and physical needs; 3. information needs; and 4. lifestyle changes. We examined the rate of moderate-to-high unmet needs based on Indigenous status (Poisson regression; incidence rate ratio (IRR)). Indigenous (n=20) and non-Indigenous (n=438) patients included in the study had similar sociodemographic and clinical characteristics except for a lower educational level among Indigenous patients (p<0.01). Most Indigenous patients (85.0%) reported having moderate-to-high unmet needs with at least one item in the SNAC tool. Following adjustment for key sociodemographic and clinical factors, Indigenous patients had a greater rate of moderate-to-high unmet needs overall (IRR=1.5, 95% CI 1.31-1.72; p<0.001), and specifically for psychosocial issues (IRR=1.7, 95% CI 1.39-2.15; p<0.001), and practical and physical needs subscales (IRR=1.5, 95% CI 1.22-1.83; p<0.001), compared to non-Indigenous patients. Indigenous Australians with cirrhosis more frequently had moderate-to-high unmet supportive care needs than non-Indigenous patients. Specific targeting of culturally appropriate supportive care for psychosocial, practical and physical needs may optimize cirrhosis care and improve the quality of life for Indigenous Australians with cirrhosis.
Identifiants
pubmed: 34853510
doi: 10.2147/PPA.S341566
pii: 341566
pmc: PMC8628121
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2649-2658Informations de copyright
© 2021 Bernardes et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
BMC Health Serv Res. 2012 Jun 10;12:151
pubmed: 22682494
BMJ Open. 2018 Jun 30;8(6):e020196
pubmed: 29961007
Patient Prefer Adherence. 2020 Mar 18;14:599-611
pubmed: 32256051
Heart Lung Circ. 2010 May-Jun;19(5-6):367-71
pubmed: 20378404
J Epidemiol Community Health. 2002 Jul;56(7):517-21
pubmed: 12080159
Int J Equity Health. 2020 Feb 17;19(1):27
pubmed: 32066438
Aliment Pharmacol Ther. 2019 Jan;49(2):194-201
pubmed: 30485460
Lancet. 2014 May 17;383(9930):1749-61
pubmed: 24480518
Liver Int. 2019 Jan;39(1):6-19
pubmed: 29935104
Med J Aust. 2018 Jun 2;209(1):16-17
pubmed: 29954309
Liver Int. 2007 Jun;27(5):654-61
pubmed: 17498251
Aust Health Rev. 2019 Apr;43(2):217-223
pubmed: 29495978
Liver Int. 2021 Jan;41(1):6-15
pubmed: 32998172
Intern Med J. 2017 Apr;47(4):429-435
pubmed: 28145084
BMJ Open. 2015 Apr 08;5(4):e007451
pubmed: 25854973
Eur J Cancer Care (Engl). 2019 Sep;28(5):e13080
pubmed: 31094021
EClinicalMedicine. 2019 Jun 13;11:44-53
pubmed: 31317132
J Nerv Ment Dis. 2010 Jan;198(1):3-7
pubmed: 20061862
JGH Open. 2020 Dec 10;5(1):133-142
pubmed: 33490623
J Hepatol. 2018 Dec;69(6):1260-1273
pubmed: 30243996
Am Fam Physician. 2014 Mar 1;89(5):392-4
pubmed: 24695513
Cancer Epidemiol Biomarkers Prev. 2011 Jan;20(1):123-33
pubmed: 21051654
Rural Remote Health. 2019 Sep;19(3):4660
pubmed: 31521102
Hepatol Commun. 2021 Feb 06;5(5):891-905
pubmed: 34027276
PLoS One. 2013 May 31;8(5):e65099
pubmed: 23741467
Gastroenterology. 2001 Jan;120(1):170-8
pubmed: 11208726