Non-medical needs in oncology patients: Patient-reported outcomes collected in a statewide consortium.

Abstract

561 Background: Unmet non-medical needs, such as housing and food insecurity, are associated with lower treatment adherence, decreased quality of life, and worse disease-specific outcomes. The purpose of this study was to examine the relationship between unmet non-medical needs and patient-reported outcomes (PROs) collected through practices in the Michigan Oncology Quality Consortium (MOQC), a statewide consortium of oncology practices focused on quality improvement. Methods: From June 2023 through November 2025, 22 medical and 6 gynecologic oncology practices collected PROs over 2-3 weeks each. The patient survey included the PROMIS pain interference and fatigue scales, selected PRO-CTCAE items, non-medical needs (Health Leads Screening), and demographics. PROMIS measures were calculated as T scores; higher values reflect worse symptoms. Inclusion criteria were age over 18 and receipt of systemic anticancer drug therapy within the past 6 weeks. The survey was available in English, Spanish, and Arabic. Results: Of the 2070 patients offered the survey, 1394 (67.3%) met eligibility criteria. Of those, 1329 (95.3%) completed the survey. Respondents were majority white (79.3%) and female (55%). Age ranged from 20 to 96 with 56% of respondents being 60-80 years old. 20% of respondents reported at least 1 non-medical need: 13% reported 1 need, 4% reported 2, and 3% reported 3 or more. The most frequently reported non-medical need was food insecurity (8.5%) followed by social isolation (7.9%). Respondents who reported a non-medical need had higher PROMIS pain interference scores (57.1 vs 52.0, p<0.001) and higher PROMIS fatigue scores (58.8 vs 53.1, p<0.001). Respondents who reported a non-medical need were also significantly more likely to report moderate or high levels of nausea frequency (33.1% vs 22.5%, p<0.001) and severity (41.2% vs 32.1%, p=0.04), vomiting frequency (9.5% vs 3.9%, p<0.001), constipation severity (24.6% vs 17.4%, p=0.007), numbness frequency (40.2% vs 29.9%, p=0.01), anxiety frequency (46.8% vs 34.1%, p<0.001) and severity (50.7% vs 34.1%, p<0.001), and sad feelings severity (46.0% vs 26.2%, p<0.001)). Conclusions: In this observational study using a convenience sample, responses to a statewide PROs survey suggest an association between unmet non-medical needs and symptoms in patients receiving cancer treatment. Our findings suggest that collection of non-medical needs can support the goals of oncology clinicians to provide precision psychosocial and supportive care.