Age-specific unmet needs among older patients with cancer enrolled in an outpatient palliative care program: A retrospective analysis.

Abstract

12096 Background: Older adults with cancer often experience diverse unmet needs. Understanding these needs is crucial for tailoring palliative care interventions. This study analyzed unmet needs among older patients enrolled in an outpatient palliative care program (OPCP), stratified by age (65–75, 76–86, and 87–97 years). Methods: This retrospective study included 474 patients enrolled in an OPCP from November 2022 to April 2024. Patients completed the Integrated Palliative Outcome Scale (IPOS), a validated measure assessing physical, psychological, social, and spiritual needs, as well as overall quality of life (QoL). Multinomial logistic regression was performed to evaluate associations between age groups and specific unmet needs, with adjustments for sociodemographic and clinical factors. Results: From the total sample, median age was 77 years (range 65–97); 51% were female, 36% had high school, and 32% were college-educated. Cancer types included gastrointestinal (25%), genitourinary (20%), lung (14%), and breast (12%). QoL scores did not differ across age groups. However, unmet needs varied by age group: 65–75 years: Greater likelihood of reporting pain (OR 0.118, 95% CI 0.01–0.42, p=0.04), fatigue (OR 8.27, 95% CI 6.76–9.96, p=0.04), drowsiness (OR 2.15, 95% CI 2.11–3.46, p=0.04), depressive symptoms (OR 2.28, 95% CI 1.23–3.35, p=0.04), and lower anxiety with treatment (OR 0.11, 95% CI 0.02–0.52, p=0.005). 76–86 years: Greater prevalence of drowsiness (OR 20.77, 95% CI 12.14–26.31, p=0.02) and reduced anxiety about the disease (OR 0.13, 95% CI 0.03–0.62, p=0.01). Feeling at peace was less common (OR 0.38, 95% CI 0.002–0.64, p=0.02). 87–97 years: More likely to report pain (OR 11.38, 95% CI 8.11–16.63, p=0.02), anxiety about the disease (OR 9.39, 95% CI 4.11–11.47, p=0.005), and satisfaction with receiving requested information (OR 6.19, 95% CI 3.71–8.42, p=0.04). Conclusions: Distinct unmet needs were identified across age groups in older cancer patients receiving outpatient palliative care. Younger older adults (65–75) had higher physical and psychological unmet needs, while the oldest patients (87–97) were more likely to report pain and anxiety about their disease but experienced better communication. Tailored interventions addressing these specific needs are essential to improving patient-centered care.