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

Florie E van Beek; Femke Jansen; Rob J Baatenburg de Jong; Johannes A Langendijk; C René Leemans; Johannes H Smit; Robert P Takes; Chris H J Terhaard; José A E Custers; Judith B Prins; Birgit I Lissenberg-Witte; Irma M Verdonck-de Leeuw

doi:10.3390/curroncol29050260

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

Curr Oncol. 2022 Apr 30;29(5):3200-3214. doi: 10.3390/curroncol29050260.

Affiliations

¹ Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
² Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
³ Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands.
⁴ Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
⁵ Department of Psychiatry, Neuroscience Campus Amsterdam and Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, 1081 HV Amsterdam, The Netherlands.
⁶ Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
⁷ Department of Radiation Oncology, University Medical Center, 3584 CX Utrecht, The Netherlands.
⁸ Department of Medical Psychology 926, Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
⁹ Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

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.

Keywords: costs; head and neck cancer; healthcare use; informal care; mental health; psychology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Delivery of Health Care
Head and Neck Neoplasms* / complications
Head and Neck Neoplasms* / therapy
Humans
Patient Care
Quality of Life* / psychology
Stress, Psychological / diagnosis

Grants and funding

This study was carried out using the research infrastructure within The Netherlands Quality of life and Biomedical Cohort study in head and neck cancer (NET-QUBIC) project funded by the Dutch Cancer Society (grant number VU 2013–5930) and the Dutch Cancer Society, Alpe Young Investigator Grant [grant number 12820]. The funding body had no role in the study design, the data collection, analysis, interpretation, or the manuscript preparation.