TY - JOUR
T1 - Disparities in Unmet Needs in Indigenous and Non-Indigenous Australians with Cirrhosis
T2 - An Exploratory Study
AU - Bernardes, Christina M.
AU - Clark, Paul J.
AU - Brown, Cath
AU - Stuart, Katherine
AU - Pratt, Gregory
AU - Toombs, Maree
AU - Hartel, Gunter
AU - Powell, Elizabeth E.
AU - Valery, Patricia C.
N1 - Publisher Copyright:
© 2021 Bernardes et al.
PY - 2021/11
Y1 - 2021/11
N2 - Purpose: 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 over-represented 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. Patients and Methods: 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)). Results: 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. Conclusion: 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.
AB - Purpose: 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 over-represented 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. Patients and Methods: 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)). Results: 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. Conclusion: 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.
KW - Chronic liver disease
KW - Indigenous Australians
KW - Patient reported outcomes
KW - Perceived needs
KW - Unmet needs
UR - http://www.scopus.com/inward/record.url?scp=85122752214&partnerID=8YFLogxK
U2 - 10.2147/PPA.S341566
DO - 10.2147/PPA.S341566
M3 - Article
AN - SCOPUS:85122752214
SN - 1177-889X
VL - 15
SP - 2649
EP - 2658
JO - Patient Preference and Adherence
JF - Patient Preference and Adherence
ER -