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Choudhury A, Shahsavar Y. Exploring the determinants influencing suicidal ideation and depression in gastrointestinal cancer patients. Sci Rep 2023; 13:18236. [PMID: 37880295 PMCID: PMC10600149 DOI: 10.1038/s41598-023-45634-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023] Open
Abstract
Studies have shown a heightened prevalence of depression and suicidal ideation among patients with Gastrointestinal Cancer (GIC). GIC patients are at a 1.5- to threefold increased risk of suicide and depression compared to other cancer patients. This study investigates the interplay of internet use, family burden, and emotional support on mental health (depression) and suicidal ideation among patients with GIC. The study involves 202 respondents of which 78 were undergoing GIC treatment during this study. Using structural equation modeling, our findings indicate a substantial negative correlation between mental health and suicidal ideation. Overall, suicidal ideation (median score) was noticeably lower in patient who completed their treatment with noticeable individuals with exceptionally high SI even after completing the treatment. Notably, participants who had completed their treatment demonstrated a significantly stronger correlation between emotional support and mental health compared to those who were still undergoing treatment. Age was found to moderate the mental health-suicidal ideation link significantly. Internet usage for health-related information was also inversely correlated with mental health (directly) and suicidal ideation (indirectly). We noted that the influence of emotional support on mental health was significantly higher among individuals who completed their treatment compared to those who were undergoing their GIC treatment. Family burden emerged as significant negative influences on mental health, while emotional support positively impacted mental health. The findings of this study contribute towards a deeper understanding of suicide risk factors in GIC patients, potentially shaping more effective preventive strategies.
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Affiliation(s)
- Avishek Choudhury
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, 1306 Evansdale Drive, Morgantown, WV, 26506, USA.
| | - Yeganeh Shahsavar
- Industrial and Management Systems Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, 1306 Evansdale Drive, Morgantown, WV, 26506, USA
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2
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Tran PB, Kazibwe J, Nikolaidis GF, Linnosmaa I, Rijken M, van Olmen J. Costs of multimorbidity: a systematic review and meta-analyses. BMC Med 2022; 20:234. [PMID: 35850686 PMCID: PMC9295506 DOI: 10.1186/s12916-022-02427-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Multimorbidity is a rising global phenomenon, placing strains on countries' population health and finances. This systematic review provides insight into the costs of multimorbidity through addressing the following primary and secondary research questions: What evidence exists on the costs of multimorbidity? How do costs of specific disease combinations vary across countries? How do multimorbidity costs vary across disease combinations? What "cost ingredients" are most commonly included in these multimorbidity studies? METHODS We conducted a systematic review (PROSPERO: CRD42020204871) of studies published from January 2010 to January 2022, which reported on costs associated with combinations of at least two specified conditions. Systematic string-based searches were conducted in MEDLINE, The Cochrane Library, SCOPUS, Global Health, Web of Science, and Business Source Complete. We explored the association between costs of multimorbidity and country Gross Domestic Product (GDP) per capita using a linear mixed model with random intercept. Annual mean direct medical costs per capita were pooled in fixed-effects meta-analyses for each of the frequently reported dyads. Costs are reported in 2021 International Dollars (I$). RESULTS Fifty-nine studies were included in the review, the majority of which were from high-income countries, particularly the United States. (1) Reported annual costs of multimorbidity per person ranged from I$800 to I$150,000, depending on disease combination, country, cost ingredients, and other study characteristics. (2) Our results further demonstrated that increased country GDP per capita was associated with higher costs of multimorbidity. (3) Meta-analyses of 15 studies showed that on average, dyads which featured Hypertension were among the least expensive to manage, with the most expensive dyads being Respiratory and Mental Health condition (I$36,840), Diabetes and Heart/vascular condition (I$37,090), and Cancer and Mental Health condition in the first year after cancer diagnosis (I$85,820). (4) Most studies reported only direct medical costs, such as costs of hospitalization, outpatient care, emergency care, and drugs. CONCLUSIONS Multimorbidity imposes a large economic burden on both the health system and society, most notably for patients with cancer and mental health condition in the first year after cancer diagnosis. Whether the cost of a disease combination is more or less than the additive costs of the component diseases needs to be further explored. Multimorbidity costing studies typically consider only a limited number of disease combinations, and few have been conducted in low- and middle-income countries and Europe. Rigorous and standardized methods of data collection and costing for multimorbidity should be developed to provide more comprehensive and comparable evidence for the costs of multimorbidity.
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Affiliation(s)
- Phuong Bich Tran
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Joseph Kazibwe
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Global Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Ismo Linnosmaa
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Mieke Rijken
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.,Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Josefien van Olmen
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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3
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van Beek FE, Jansen F, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Smit JH, Takes RP, Terhaard CHJ, Custers JAE, Prins JB, Lissenberg-Witte BI, Verdonck-de Leeuw IM. Psychological Problems among Head and Neck Cancer Patients in Relation to Utilization of Healthcare and Informal Care and Costs in the First Two Years after Diagnosis. Curr Oncol 2022; 29:3200-3214. [PMID: 35621650 PMCID: PMC9139910 DOI: 10.3390/curroncol29050260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/13/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background: To investigate associations between psychological problems and the use of healthcare and informal care and total costs among head and neck cancer (HNC) patients. Method: Data were used of the NETherlands QUality of Life and Biomedical Cohort study. Anxiety and depression disorder (diagnostic interview), distress, symptoms of anxiety and depression (HADS), and fear of cancer recurrence (FCR) and cancer worry scale (CWS) were measured at baseline and at 12-month follow-up. Care use and costs (questionnaire) were measured at baseline, 3-, 6-, 12-, and 24-month follow-up. Associations between psychological problems and care use/costs were investigated using logistic and multiple regression analyses. Results: Data of 558 patients were used. Distress, symptoms of anxiety or depression, FCR, and/or anxiety disorder at baseline were significantly associated with higher use of primary care, supportive care, and/or informal care (odds ratios (ORs) between 1.55 and 4.76). Symptoms of anxiety, FCR, and/or depression disorder at 12-month follow-up were significantly associated with use of primary care, supportive care, and/or informal care (ORs between 1.74 and 6.42). Distress, symptoms of anxiety, and FCR at baseline were associated with higher total costs. Discussion: HNC patients with psychological problems make more use of healthcare and informal care and have higher costs. This is not the result of worse clinical outcomes.
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Affiliation(s)
- Florie E. van Beek
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands;
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (C.R.L.); (I.M.V.-d.L.)
- Correspondence:
| | - Rob J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands;
| | - Johannes A. Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - C. René Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (C.R.L.); (I.M.V.-d.L.)
| | - Johannes H. Smit
- Department of Psychiatry, Neuroscience Campus Amsterdam and Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, 1081 HV Amsterdam, The Netherlands;
| | - Robert P. Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Chris H. J. Terhaard
- Department of Radiation Oncology, University Medical Center, 3584 CX Utrecht, The Netherlands;
| | - José A. E. Custers
- Department of Medical Psychology 926, Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (J.A.E.C.); (J.B.P.)
| | - Judith B. Prins
- Department of Medical Psychology 926, Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (J.A.E.C.); (J.B.P.)
| | - Birgit I. Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Irma M. Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (C.R.L.); (I.M.V.-d.L.)
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Nallani R, Smith JB, Penn JP, Bur AM, Kakarala K, Shnayder Y, Villwock MR, Sykes KJ. Decision regret 3 and 6 months after treatment for head and neck cancer: An observational study of associations with clinicodemographics, anxiety, and quality of life. Head Neck 2021; 44:59-70. [PMID: 34704319 DOI: 10.1002/hed.26911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND While quality of life (QOL), psychosocial health, and adverse treatment outcomes have been studied in head and neck cancer (HNC) patients, decision regret is an important and understudied complication that can negatively impact future health care decision making. METHODS Data collected using a HNC patient registry with questionnaires administered at initial consultation visits plus 3 and 6 months after treatment completion was retrospectively analyzed. A visual analog anxiety scale and the University of Washington Quality of Life were given at clinic visits. Decision regret was determined using a validated scale. Demographic and clinical variables were collected retrospectively and at baseline. RESULTS Patients with higher anxiety and lower self-reported QOL had higher concurrent regret at 3-month (n = 140) and at 6-month (n = 82) post-treatment. Later disease stage at presentation, nonprimary surgical treatment, and lower health literacy were associated with greater regret. CONCLUSIONS Decision regret was highest in HNC patients with high anxiety, low QOL, and more advanced disease.
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Affiliation(s)
- Rohit Nallani
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Joshua B Smith
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University, St. Louis, Missouri, USA
| | - Joseph P Penn
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Andres M Bur
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kiran Kakarala
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Yelizaveta Shnayder
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mark R Villwock
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kevin J Sykes
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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Balachandra S, Eary RL, Lee R, Wynings EM, Sher DJ, Sura T, Liu Y, Tillman BN, Sumer BD, Arnold EM, Tiro JA, Lee SC, Day AT. Substance use and mental health burden in head and neck and other cancer survivors: A National Health Interview Survey analysis. Cancer 2021; 128:112-121. [PMID: 34499355 DOI: 10.1002/cncr.33881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/17/2021] [Accepted: 02/13/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Tobacco dependence, alcohol abuse, depression, distress, and other adverse patient-level influences are common in head and neck cancer (HNC) survivors. Their interrelatedness and precise burden in comparison with survivors of other cancers are poorly understood. METHODS National Health Interview Survey data from 1997 to 2016 were pooled. The prevalence of adverse patient-level influences among HNC survivors and matched survivors of other cancers were compared using descriptive statistics. Multivariable logistic regressions evaluating covariate associations with the primary study outcomes were performed. These included 1) current cigarette smoking and/or heavy alcohol use (>14 drinks per week) and 2) high mental health burden (severe psychological distress [Kessler Index ≥ 13] and/or frequent depressive/anxiety symptoms). RESULTS In all, 918 HNC survivors and 3672 matched survivors of other cancers were identified. Compared with other cancer survivors, more HNC survivors were current smokers and/or heavy drinkers (24.6% [95% CI, 21.5%-27.7%] vs 18.0% [95% CI, 16.6%-19.4%]) and exhibited a high mental health burden (18.6% [95% CI, 15.7%-21.5%] vs 13.0% [95% CI, 11.7%-14.3%]). In multivariable analyses, 1) a high mental health burden predicted for smoking and/or heavy drinking (odds ratio [OR], 1.4; 95% CI, 1.0-1.9), and 2) current cigarette smoking predicted for a high mental health burden (OR, 1.7; 95% CI, 1.2-2.3). Furthermore, nonpartnered marital status and uninsured/Medicaid insurance status were significantly associated with both cigarette smoking and/or heavy alcohol use (ORs, 1.9 [95% CI, 1.4-2.5] and 1.5 [95% CI, 1.0-2.1], respectively) and a high mental health burden (ORs, 1.4 [95% CI, 1.1 -1.8] and 3.0 [95% CI, 2.2-4.2], respectively). CONCLUSIONS Stakeholders should allocate greater supportive care resources to HNC survivors. The interdependence of substance abuse, adverse mental health symptoms, and other adverse patient-level influences requires development of novel, multimodal survivorship care interventions.
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Affiliation(s)
- Sanjana Balachandra
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca L Eary
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca Lee
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Erin M Wynings
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - David J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Teena Sura
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yulun Liu
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Brittny N Tillman
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Baran D Sumer
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Mayfield Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jasmin A Tiro
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Simon C Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
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6
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Howren MB, Seaman A, Christensen AJ, Pagedar NA. Association of depressive symptomatology with problem alcohol use in rural head and neck cancer patients at diagnosis. J Psychosoc Oncol 2021; 40:868-880. [PMID: 34486953 DOI: 10.1080/07347332.2021.1971816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Problem alcohol use is a risk factor for the development of head and neck cancer (HNC) and continued use is associated with poor outcomes; depressive symptoms may be associated with this behavior. DESIGN Exploratory cross-sectional study examined depressive symptoms as a correlate of self-reported problem alcohol use at diagnosis. SAMPLE/METHODS Multivariable linear regression examined depressive symptoms as a correlate of problem alcohol use in a sample of rural HNC patients (N = 249). FINDINGS Over half (55.2%) of rural patients with potentially problem alcohol use exhibited mild to moderate depressive symptomatology. Regression models controlling for age, cancer site, stage, sex, tobacco use, and treatment modality indicated that depressive symptoms at diagnosis were associated with self-reported problem alcohol use scores at diagnosis (ß = .186, sr2 = .031, p < .01). Follow-up subgroup analyses demonstrated that depressive symptoms at diagnosis were significantly associated with self-reported problem alcohol use in male patients, those with advanced stage disease, and of older age. CONCLUSIONS/IMPLICATIONS HNC patients should be screened for alcohol use and depression at diagnosis. Access to behavioral health treatment and/or referral options may be lacking in rural areas thus additional ways of connecting rural patients to specialty care should be explored. These may include telehealth and multimodal interventions to address complex behavioral health cases. Additional research in important patient subgroups such as older patients and those presenting with advanced disease is also warranted.
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Affiliation(s)
- M Bryant Howren
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA.,Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA.,Florida Blue Center for Rural Health Research and Policy, College of Medicine, Florida State University, Tallahassee, FL, USA.,Center for Access Delivery Research and Evaluation (CADRE), VA Iowa City Healthcare System, Iowa City, IA, USA
| | - Aaron Seaman
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA.,Center for Access Delivery Research and Evaluation (CADRE), VA Iowa City Healthcare System, Iowa City, IA, USA.,Department of Internal Medicine, The University of Iowa, Iowa City, IA, USA
| | - Alan J Christensen
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA.,Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Nitin A Pagedar
- Department of Otolaryngology-Head and Neck Surgery, Carver College of Medicine, The University of Iowa, Iowa City, IA, USA
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7
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Gao J, Tseng CC, Barinsky GL, Povolotskiy R, Grube JG, Baredes S, Park RCW. Exploratory analysis on the association of mental health disorders with in-hospital postoperative complications and mortality in head and neck cancer surgery. Head Neck 2021; 43:3022-3031. [PMID: 34180571 DOI: 10.1002/hed.26791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/16/2021] [Accepted: 06/10/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The objective was to assess the association of mental health disorders with in-hospital complication and mortality rates in patients undergoing head and neck cancer surgery. METHODS In this exploratory retrospective study, the Nationwide Inpatient Sample was queried from 2003 to 2014 for all patients with a diagnosis of head and neck cancer who underwent surgery. Univariate cross-tabulation, logistic regression, and propensity score matching (PSM) were used to compare demographics, procedure-related variables, and in-hospital postoperative complications and mortality between patients with and without selected comorbid mental health disorders. RESULTS Of 39 600 included patients, 3390 (8.6%) had a selected comorbid mental health disorder diagnosis. After PSM, patients with selected mental health disorders had increased risk of overall medical complications on multivariable analysis (OR 1.28 [CI 1.12-1.46], P < 0.001) but not overall surgical complications or mortality. CONCLUSIONS Patients with a mental health disorder diagnosis have increased risk of in-hospital medical, certain surgical, and total complications.
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Affiliation(s)
- Jeff Gao
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Christopher C Tseng
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Gregory L Barinsky
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Roman Povolotskiy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jordon G Grube
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
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Van Beek FE, Wijnhoven LMA, Holtmaat K, Custers JAE, Prins JB, Verdonck-de Leeuw IM, Jansen F. Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review. Psychooncology 2021; 30:1801-1835. [PMID: 34228838 PMCID: PMC9291760 DOI: 10.1002/pon.5753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/14/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study systematically reviewed the association of psychological problems among cancer patients with healthcare and societal resource use and costs. METHODS PubMed, PsycINFO, and Embase were searched (until 31 January 2021) for studies on psychological symptoms (anxiety, depression, distress, fear of recurrence) or psychiatric disorders (anxiety, depression, adjustment) and healthcare use (e.g., mental, inpatient healthcare), economic losses by patients and family, economic losses in other sectors (e.g., absence from work), and costs. The search, data extraction, and quality assessment were performed by two authors. RESULTS Of the 4157 identified records, 49 articles were included (psychological symptoms (n = 34), psychiatric disorders (n = 14), both (n = 1)) which focused on healthcare use (n = 36), economic losses by patients and family (n = 5), economic losses in other sectors (n = 8) and/or costs (n = 13). In total, for 12 of the 94 associations strong evidence was found. Psychological symptoms and psychiatric disorders were positively associated with increased healthcare use (mental, primary, inpatient, outpatient healthcare), losses in other sectors (absence from work), and costs (inpatient, outpatient, total healthcare costs). Moderate evidence was found for a positive association between (any) psychiatric disorder and depression disorder with inpatient healthcare and medication use, respectively. CONCLUSIONS Psychological problems in cancer patients are associated with increased healthcare use, healthcare costs and economic losses. Further research is needed on psychological problems in relation to understudied healthcare use or costs categories, productivity losses, and informal care costs.
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Affiliation(s)
- Florie E Van Beek
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lonneke M A Wijnhoven
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Karen Holtmaat
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands
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