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

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.

Mental healthcare utilization among head and neck cancer patients: A longitudinal cohort study

“…Except for the association between mental healthcare utilization and disease stage and living situation, factors associated with mental healthcare utilization were comparable to those found among subgroups with mild‐severe or severe psychological symptoms. The finding that increased levels of symptoms of anxiety, higher need for mental healthcare, lower age, and higher level of seeking social support are associated with increased mental healthcare use is in line with previous research 5,9,11,15,19,37 . The association between higher disease stage and mental healthcare utilization among HNC patients was unexpected, as previous research among Dutch HNC patients showed no such association 9 .…”

“…The finding that increased levels of symptoms of anxiety, higher need for mental healthcare, lower age, and higher level of seeking social support are associated with increased mental healthcare use is in line with previous research. 5,9,11,15,19,37 The association between higher disease stage and mental healthcare utilization among HNC patients was unexpected, as previous research among Dutch HNC patients showed no such association. 9 An explanation may be that HNC patients with a higher disease stage are likely to have more medical contacts within the hospital (e.g.…”

“…In addition, fieldwork assessments (interview and objective tests) and collection of biobank materials take place at baseline, 3 and 6 months, and 1, 2 and 5 years after treatment. Previous NET‐QUBIC publications provided detailed insight into the study design, representativeness of the cohort, study retention, supportive care needs and healthcare utilization 17–21 …”

“…Previous NET-QUBIC publications provided detailed insight into the study design, representativeness of the cohort, study retention, supportive care needs and healthcare utilization. [17][18][19][20][21] Patients were included (2014-2018) from university medical centers and general hospitals throughout the Netherlands. Inclusion criteria were newly-diagnosed HNC (oral cavity, oropharynx, hypopharynx, larynx, unknown primary; all stages); age >18 years; treatment with curative intent; all treatment modalities; able to write, read, and speak Dutch.…”

Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program

“…Various studies have estimated that 10–40% of cancer survivors experience significant levels of distress [ 9 , 10 , 11 ]. Distress has a negative effect on patients and is associated with important aspects of cancer outcome including quality of life, performance status, treatment adherence, and healthcare utilization [ 12 , 13 ].…”