title: Is social inequality related to different patient concerns in routine oral cancer follow-up clinics?
abstract: Oral cancer has a higher incidence in the lower social strata, and these patients are less likely to engage in supportive interventions and report a poorer quality of life (QoL). The aim of this paper is to compare the Patient Concerns Inventory (PCI) responses across social groups attending routine oral cancer follow-up clinics with particular focus on the deprivation lower quartile. The PCI package is completed by patients as part of their routine review consultation with SNR. Patients were those diagnosed between 2008 and 2012. Deprivation was stratified using the IMD 2010 from postcode. Of the 106 eligible patients, 85 % used the PCI. Just over half (54 %) were living in the most deprived quartile, with two-thirds (68 %) of males in the most deprived quartile, compared with 35 % of females (p = 0.004). In regard to number and type of PCI items selected by patients at their first PCI clinic, there were no notable differences in respect of IMD classification. The two commonest concerns were fear of recurrence (43 %) and sore mouth (43 %). The most deprived quartile reported significant problems in regard to mood (p = 0.004) and recreation (p = 0.02), and a non-significant trend (36 vs 18 %, p = 0.09) in stating their overall QoL as being less than good. It is possible to identify the concerns of patients from lower socioeconomic strata as part of routine follow-up clinics. This allows for targeted multi-professional intervention and supports to improve the outcome in this hard to reach group.
authors.affiliation: Department of Health Services Research, Institute of Psychology Health and Society, University of Liverpool, Room 111, 1st floor, Block B, Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL, UK. Sarah.Allen@liverpool.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Allen
authors.affiliation: Faculty of Health and Social Care, Evidence-Based Practice Research Centre (EPRC), Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK.|Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.affiliation: Department of Health Services Research, Institute of Psychology Health and Society, University of Liverpool, Room 111, 1st floor, Block B, Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL, UK.
authors.forename: Rebecca V
authors.initials: RV
authors.lastname: Harris
authors.affiliation: Department of Psychological Sciences, University of Liverpool, Liverpool, L69 3BX, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Brown
authors.affiliation: Faculty of Health and Social Care, Evidence-Based Practice Research Centre (EPRC), Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK.|Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
authors.forename: Simon N
authors.initials: SN
authors.lastname: Rogers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D000554:Ambulatory Care Facilities; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000628:therapy; D011204:Poverty Areas; D011788:Quality of Life; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Health-related quality of life; Oral cancer; Patient concerns inventory; Patient reported outcomes; Social deprivation