(PS2-23) Unmet Supportive Care Needs and patient-reported outcomes (PROs) among Hispanic and non-Hispanic older ambulatory oncology patients

Abstract Text:

Background: Older (> 65 years old) Hispanic cancer patients experience marked disparities in survivorship outcomes, as evidenced by patient-reported outcomes (PROs). These disparities have been linked to greater unmet supportive care needs (USCNs) and worse clinical outcomes, primarily among non-Hispanic White populations. This study examined differences in USCNs and PROs among older Hispanic and non-Hispanic ambulatory oncology patients.

Methods: Between October 2019 and September 2024, 8,996 (3,297 Hispanic, 5,699 Non-Hispanic) older (≥65) ambulatory oncology patients at a South Florida cancer center completed the My Wellness Check (MWC) questionnaire. MWC is an electronic health record-integrated assessment of PROs, including PROMIS® computerized adaptive tests of pain interference, fatigue, physical function, anxiety, and depression, USCNs, and health-related quality of life (HRQOL, FACT-G7). Descriptive statistics were calculated for sociodemographic and medical characteristics using Chi-square tests and T-tests. The frequency of patients with each USCN was compared between Hispanic and non-Hispanic groups using Chi-square tests.

Results: On average, Hispanic patients were 73.7±6.4 years old and primarily male (54%), White (96%), insured (97%), and married (60%). Non-Hispanic patients, on average, were 74.2±6.2 years old and primarily female (57%), White (86%), insured (98%), and married (66%). Hispanic participants were significantly more likely to report at least one need (32% vs. 23%, p<.0001) and had significantly higher levels of USCNs than non-Hispanic participants (M=0.9, SD=1.8 vs. M=0.5, SD=1.3, p<.0001). Compared to non-Hispanic patients, a significantly higher proportion of Hispanics reported unmet needs in several areas, including informational (i.e., cancer education), psychological (i.e., disease coping), practical (i.e., transportation, food, housing, access to medicine, financial/insurance concerns), social/daily living (e.g., familial problems, taking care of oneself and others) (all p’s <.001). Hispanic patients also reported significantly higher levels of anxiety, fatigue, and declined physical function than non-Hispanics (all p’s <.001).

Conclusions: Older Hispanic patients reported more USCNs, and worse PROs compared to non-Hispanic patients. Hispanic patients over 65 years old may benefit from timely referral to supportive care services and engagement in psychosocial interventions tailored to address their unique needs. Further research is needed to assess the clinical implications of these differences and to develop targeted interventions that mitigate this healthcare burden.