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
Presenter Ave Mori
Authors A. Mori1, A. Goren2, I. Gilloteau3, M.D. Dibonaventura4
  • 1Global Medical Affairs, Bristol-Myers Squibb, 92500 - Rueil-Malmaison/FR
  • 2Health Sciences Practice, Kantar Health, 10010 - New York/US
  • 3Eu Heor Oncology, Bristol-Myers Squibb, 92500 - Rueil-Malmaison/FR
  • 4Health Sciences Practice, Kantar Health, Fl 12 - New York/US

Abstract

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.