The Association Between Area Deprivation Index and Patient-Reported Outcomes in Patients with Advanced Cancer

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, similar to 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.

Automated summary

The study found that higher Area Deprivation Index (ADI) was associated with increased levels of anxiety among patients with advanced cancer. Geographic information could assist clinicians in providing geographically influenced social support strategies.