Open AccessThe Association Between Area Deprivation Index and Patient-Reported Outcomes in Patients with Advanced Cancer
Author(s) -
Margaret Rosenzweig,
Andrew D. Althouse,
Lindsay M. Sabik,
Robert M. Arnold,
Edward Chu,
Thomas J. Smith,
Kenneth J. Smith,
Douglas B. White,
Yael Schenker
Publication year - 2021
Publication title -
health equity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.826
H-Index - 9
ISSN - 2473-1242
DOI - 10.1089/heq.2020.0037
Subject(s) - medicine , hospital anxiety and depression scale , anxiety , quality of life (healthcare) , multivariate analysis , depression (economics) , palliative care , cancer , lung cancer , univariate analysis , social deprivation , gerontology , psychiatry , nursing , economics , macroeconomics , economic growth
Background: This analysis describes associations between area deprivation and patient-reported outcomes among patients with advanced cancer. Methods: This is a cross-sectional analysis of baseline data from a multisite primary palliative care intervention trial. Participants were adult patients with advanced cancer. Patient-level area deprivation scores were calculated using the Area Deprivation Index (ADI). Quality of life and symptom burden were measured. Uni- and multivariate regressions estimated associations between area deprivation and outcomes of interest. Results: Among 672 patients, ∼0.5 (54%) were women and most (94%) were Caucasian. Mean age was 69.3±10.2 years. Lung (36%), breast (13%), and colon (10%) were the most common malignancies. Mean ADI was 64.0, scale of 1 (low)-100 (high). In unadjusted univariate analysis, Functional Assessment of Cancer Therapy-Palliative ( p =0.002), Edmonton Symptom Assessment Scale ( p =0.025) and the Hospital Anxiety and Depression Scale anxiety ( p =0.003) and depression ( p =0.029) scores were significantly associated with residence in more deprived areas ( p =0.003). In multivariate analysis, controlling for patient-level factors, living in more deprived areas was associated with more anxiety ( p =0.019). Conclusion: Higher ADI was associated with higher levels of anxiety among patients with advanced cancer. Geographic information could assist clinicians with providing geographically influenced social support strategies.