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Unmet supportive care needs, health status and minimum costs in survivors of malignant melanoma
Author(s) -
Davies L.M.,
Hayhurst K.P.,
Lorigan P.,
Molassiotis A.
Publication year - 2018
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12811
Subject(s) - medicine , psychological intervention , quality of life (healthcare) , anxiety , depression (economics) , melanoma , health care , gerontology , psychiatry , nursing , cancer research , economics , macroeconomics , economic growth
We explored the relationship between unmet care needs, health status, health utility and costs in people treated for melanoma via a cross‐sectional follow‐up survey ( N = 455) 3 months to 5 years after complete resection of stage I– III cutaneous malignant melanoma. 51% ( n = 232) had unmet care needs. This group had higher mean resource use, estimated conservatively (£28 vs. £10 per person) and worse overall health. Mean health‐related utility index ( AQ oL6D) was 0.763 (95% CI 0.74; 0.79) in those with self‐reported unmet need vs. 0.903 (0.89; 0.92) in those with no unmet need. Melanoma survivors with unmet need had worse outcomes in terms of anxiety ( HADS 6.86 vs. 4.29), depression ( HADS 4.29 vs. 2.01), overall quality of life (QoL: FACT ‐M 84.2 vs. 96.5). Higher resource use was associated with younger age ( r s = −.29, p < .001), older school‐leaving age ( r s = .21, p < .001), reduced health utility ( r s = −.14, p = .005), higher anxiety ( r s = .22, p < .001), higher depression ( r s = .16, p = .001) and lower QoL (overall r s = −.24, p < .001; melanoma QoL r s = −.20, p < .001; surgery QoL r s = −.19, p < .001). Lower health outcomes indicate increased service use, suggesting that interventions to address unmet need and improve health outcomes may reduce health costs. Integrated clinical and economic evaluations of interventions that target unmet need in melanoma survivors are required.