Abstract

Background

Gliomas are associated with significant healthcare burden, yet reports of costs are scarce. While many costs are unavoidable there may be treatable symptoms contributing to higher costs. We describe healthcare and societal costs in glioma patients at high risk for depression and their family caregivers, and explore relationships between costs and treatable symptoms.

Methods

Data from a multicenter randomized trial on effects of internet-based therapy for depressive symptoms were used (NTR3223). Costs of self-reported healthcare utilization, medication use, and productivity loss were calculated for patients and caregivers separately. We used generalized linear regression models to predict costs with depressive symptoms, fatigue, cognitive complaints, tumor grade (low-/high-grade), disease status (stable or active/progression), and intervention (use/non-use) as predictors.

Results

Multiple assessments from baseline through 12 months from 91 glioma patients and 46 caregivers were used. Mean overall costs per year were M = €20,587.53 (sd = €30,910.53) for patients and M = €5,581.49 (sd = €13,102.82) for caregivers. In patients, higher healthcare utilization costs were associated with more depressive symptoms; higher medication costs were associated with active/progressive disease. In caregivers, higher overall costs were linked with increased caregiver fatigue, cognitive complaints, and lower patient tumor grade. Higher healthcare utilization costs were related to more cognitive complaints and lower tumor grade. More productivity loss costs were associated with increased fatigue (all P < 0.05).

Conclusions

There are substantial healthcare and societal costs for glioma patients and caregivers. Associations between costs and treatable psychological symptoms indicate that possibly, adequate support could decrease costs.

Trial registration

Netherlands Trial Register NTR3223.

中文翻译：

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神经胶质瘤患者和家庭护理人员的医疗保健利用率和生产力损失：可治疗的心理症状的影响。

摘要

背景

脑胶质瘤与巨大的医疗保健负担有关，但很少有成本报告。虽然许多费用是不可避免的，但可能会有可治愈的症状导致费用增加。我们描述了高抑郁症风险的神经胶质瘤患者及其家庭护理人员的医疗保健和社会成本，并探讨了成本与可治疗症状之间的关系。

方法

使用了一项基于互联网的抑郁症状治疗的多中心随机试验的数据（NTR3223）。分别计算患者和护理人员的自我报告的医疗保健使用，药物使用和生产力损失的成本。我们使用广义线性回归模型以抑郁症状，疲劳，认知障碍，肿瘤等级（低/高等级），疾病状态（稳定或活动/进展）和干预（使用/不使用）作为预测指标来预测成本。

结果

从基线到12个月，对91位神经胶质瘤患者和46位护理人员进行了多次评估。每年平均总成本为中号 =€20,587.53（SD 患者和=€30,910.53）中号 =€5,​​581.49（SD  =€13,102.82）护理人员。在患者中，更高的医疗保健利用成本与更多的抑郁症状相关。较高的药物治疗费用与活动性/进行性疾病相关。在照顾者中，较高的总体成本与护理人员疲劳度增加，认知障碍和患者肿瘤分级降低有关。更高的医疗保健利用成本与更多的认知障碍和更低的肿瘤等级有关。更高的生产力损失成本与疲劳增加有关（所有P  <0.05）。

结论

对于神经胶质瘤患者和护理者而言，其医疗和社会费用很高。费用与可治疗的心理症状之间的联系表明，适当的支持可能会降低费用。

试用注册

荷兰审判注册簿NTR3223。