Role of cancer survivor health and health service use in spouses' use of mental health–related care

Abstract

Background Spouses of cancer survivors are at an increased risk of poor mental health outcomes but are known to underuse supportive services. The objective of the current study was to determine how the health and health care use of cancer survivors were associated with depression and anxiety‐related health care use in their spouses. Methods The current observational study used data from the Medical Expenditure Panel Survey to identify married individuals with a cancer‐related medical event or disability (“cancer survivors”), and linked health and health care use data across spousal dyads. Spouses reporting a prescription for an antidepressant or antianxiety medication or any psychotherapy were flagged as having used mental health care. Correlates of use were assessed, with a focus on the health and health care use of the cancer survivor. Results Greater than 25% of the spouses of cancer survivors used mental health care over the approximately 2.5 years of follow‐up. Controlling for their own predisposing, enabling, and need characteristics, spouses were found to be less likely to use mental health care if the cancer survivor reported more health conditions or elevated depressed mood compared with dyads in which the survivor reported low distress and depression. Spouses were nearly 3 times more likely to use mental health care if the cancer survivor themselves had used mental health care (odds ratio, 2.98; 95% confidence interval, 2.17‐4.09). Conclusions The findings of the current study enhance understanding of how health outcomes are intertwined in families with cancer, and reinforce the importance of a family‐centered approach to cancer care that facilitates psychosocial care. LAY SUMMARY The health and well‐being of cancer survivors and their spouses are intertwined. The results of the current study demonstrated that this interrelationship extends to mental health care related to depression and anxiety. Spouses of cancer survivors were found to be less likely to receive mental health care when the survivor had more health care needs. Spouses were nearly 3 times more likely to receive care if the survivor also was receiving mental health care. Caregiving spouses may face more challenges finding the time, money, or energy to engage in their own self‐care. However, providing supportive care to one partner may help the other partner access care as well.

Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review

“…Of these studies 272 were selected for full text review (Figure 2). In total 49 studies 24–71 fulfilled the eligibility criteria and were included in this systematic review. The majority of the studies focused on healthcare use ( n = 36) 24,25,27–29,31,33–35,37–39,41–48,51,53,54,56–62,64,67,69–72 followed by studies on costs in monetary units ( n = 13), 26,29,34,36,38,42–44,48,53,55,57,61 economic losses in other sectors ( n = 8) 30,32,40,49,63,65,66,68 and economic losses by patients and family ( n = 6) 28,29,50,52,64,69 .…”

“…In total 49 studies 24–71 fulfilled the eligibility criteria and were included in this systematic review. The majority of the studies focused on healthcare use ( n = 36) 24,25,27–29,31,33–35,37–39,41–48,51,53,54,56–62,64,67,69–72 followed by studies on costs in monetary units ( n = 13), 26,29,34,36,38,42–44,48,53,55,57,61 economic losses in other sectors ( n = 8) 30,32,40,49,63,65,66,68 and economic losses by patients and family ( n = 6) 28,29,50,52,64,69 . Thirteen studies 28,29,34,38,42–44,48,53,57,61,69 focused on two or more of these categories (e.g., healthcare use and costs in monetary units), resulting in a total sum greater than 49 studies.…”

“…In summary, all studies were published between 1972 and 2020, of which 24 studies 24,26–30,32,35–37,43,48–50,53,55–57,60,62,63,65,67,70,71 were published after December 2017. Most of the studies were conducted in the United States ( N = 27), 27,34‐38,41–44,46,50,52–61,66,70–72 Netherlands ( N = 8), 26,29,30,39,45,67,68 Germany ( N = 3) 33,64,65 and Canada ( N = 3) 28,47,51 .…”

“…In summary, all studies were published between 1972 and 2020, of which 24 studies 24,26–30,32,35–37,43,48–50,53,55–57,60,62,63,65,67,70,71 were published after December 2017. Most of the studies were conducted in the United States ( N = 27), 27,34‐38,41–44,46,50,52–61,66,70–72 Netherlands ( N = 8), 26,29,30,39,45,67,68 Germany ( N = 3) 33,64,65 and Canada ( N = 3) 28,47,51 . Studies were most often performed among mixed cancer patients ( N = 20) 27–29,33,36–38,41,44,47,50,53,54,61–64,66,68,70 and breast cancer patients ( N = 11) 32,34,38,45,49,52,59,60,63,65,71 .…”

“…Most of the studies were conducted in the United States ( N = 27), 27,34‐38,41–44,46,50,52–61,66,70–72 Netherlands ( N = 8), 26,29,30,39,45,67,68 Germany ( N = 3) 33,64,65 and Canada ( N = 3) 28,47,51 . Studies were most often performed among mixed cancer patients ( N = 20) 27–29,33,36–38,41,44,47,50,53,54,61–64,66,68,70 and breast cancer patients ( N = 11) 32,34,38,45,49,52,59,60,63,65,71 . Other studies were performed across a variety of other cancer patients: colorectal ( N = 5) 25,30,38,39,67 prostate cancer ( N = 2) 38,42 , lung cancer ( N = 3), 55,56,72 hepatocellular carcinoma ( N = 2), 48,57 head and neck cancer ( N = 2), 43,46 Gynecologic cancer ( N = 1) 31 , glioma cancer ( N = 1), 26 gastrointestinal cancer ( N = 1), 35 hematological malignancy ( N = 1) 40 and lymphoma ( N = 1) 24 patients.…”