Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Psychological multimorbidity and psychological impacts of multimorbidity in cancer: considerations for development of a clinical pathway (126262)

Emma Kemp 1 , Monique Bareham 1 , Cartier Dods 1 2 , Sharon Lawn 1 , Richard L Reed 1 , Lisa Beatty 2 , Jackie Roseleur 1 , Katia Ferrar 1 , Bogda Koczwara 1 3
  1. College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
  2. Flinders University College of Education Psychology and Social Work, Flinders University Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
  3. Australian Research Centre for Cancer Survivorship, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia

Purpose/objectives:

Multimorbidity, defined as “co-occurrence of two or more long-term conditions”, impacts all stages of cancer care, increases prognosis uncertainty and care complexity, and is associated with adverse outcomes, including increased mortality, disability, hospital admissions, and health service utilisation, reduced quality of life, and psychological outcomes such as increased anxiety and/or depression. This study aimed to examine consumer and health care professional (HCP) experiences of multimorbidity in cancer care, to inform development of a prototype clinical pathway to improve management of multimorbidity, with specific consideration of psychological multimorbidity and of psychological impacts of multimorbidity.

Sample and setting:

Qualitative focus groups and interviews were conducted online, via telephone or in-person with adults with history of cancer and/or cancer caregiving and HCPs experienced in cancer care, recruited for information power.

Procedure:

Semi-structured consultations focused on participants’ experiences of barriers, facilitators and impact of management of multimorbidity in cancer, and elicited suggestions regarding optimal models of care for multimorbidity management. Consultations were analysed thematically.  

Results:

Participants included 26 consumers with breast, lung, prostate, or other cancers; and 24 HCPs including oncology, nursing, primary care, mental health and other allied health professionals.  Consideration of psychological multimorbidity (e.g. co-occurring anxiety) was recognised as vital in management of multimorbidity. Despite this, psychological multimorbidity was not always screened, recognised or treated sufficiently. Insufficient acknowledgement, communication, or consideration of multimorbidity (in general) had marked psychological impacts, thus increasing multimorbidity complexity. Access to dedicated mental health specialists and/or health professionals with specialist mental health training was identified as an important element of any model of care for managing multimorbidity in cancer.

Conclusion and clinical implications:

Findings highlight need for mental health expertise to manage psychological multimorbidity and psychological impacts of multimorbidity in clinical pathways for multimorbidity management, contrasting with  minimal reference to mental health expertise in key cancer policies.