1418PD_PR - Quantifying the burden of caregiving for patients with cancer in Europe
|Date||01 October 2012|
|Event||ESMO Congress 2012|
|Session||Public health and familial cancer|
|Topics|| Bioethics, Legal, and Economic Issues
A. Mori1, A. Goren2, I. Gilloteau3, M.D. Dibonaventura4
Background: It is recognized that cancer imposes a burden both on patients and on those who provide care for them, but the extent of this burden compared to non-caregivers is unknown.
Methods: Data were obtained from the 2010 EU National Health and Wellness Survey (NHWS), a self-administered online survey of adults in France, Germany, Italy, Spain, and the United Kingdom (n=57,805). Stratified random sampling matched the NHWS with each country's demographic composition. Respondents who reported providing care for a patient with cancer (called informal "caregivers") were compared with respondents not providing care ("non-caregivers") on health status (from the Short Form (SF)-12 and SF-6D health utility measure), work impairment from the Work Productivity and Activity Impairment (WPAI) questionnaire, diagnosed comorbid illness, and self-reported healthcare resource use. Regression models were used to predict health outcomes as a function of caregiving vs. non-caregiving, controlling for demographics, health risk behaviors, and Charlson Comorbidity Index.
Results: Adjusting for covariates, caregivers (n=847) reported significantly worse health status than non-caregivers (n=52,127) (physical: -1.32 points; mental: -3.21 points; health utilities: -0.043 points, all p<.001), and during the last week higher mean levels of absenteeism (8.39% vs. 4.76%), overall work impairment (26.43% vs. 18.09%) and activity impairment (28.85% vs. 21.91%) (all p<.001). In addition, caregivers reported more mean healthcare provider visits (6.53 vs. 4.89, p<.001), emergency room visits (0.26 vs. 0.16, p=.002) and hospitalizations (0.19 vs. 0.10, p=.003) during the last 6 months. Caregivers had greater likelihood than non-caregivers of being diagnosed with depression (OR=1.455), anxiety (OR=1.972), insomnia (OR=1.945), migraine (OR=1.697), and gastrointestinal problems (OR=1.644) (all p<.001).
Conclusion: Cancer caregivers experience a significantly higher burden than non-caregivers, adding to the already high societal cost of cancer. Special attention to caregivers should be given based on their pivotal role in maintaining the health and well-being of patients with cancer, fulfilling a need not addressed by the healthcare system.