2
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Financial toxicity and mental well‐being of the oral cancer survivors residing in a developing country in the era of COVID 19 pandemic – A cross‐sectional study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives

          The primary outcome measures evaluated the financial toxicity and mental well‐being of the oral cancer survivors.

          Methods

          A cross‐sectional study of oral cancer survivors who were disease‐free for more than 6 months after treatment and visited the hospital for a routine follow‐up is included in the study. Mental well‐being and financial toxicity were evaluated using the Depression, Anxiety, and Stress Scale ‐ 21 (DASS 21) and Comprehensive Score for financial Toxicity (COST‐ Functional Assessment of Chronic Illness Therapy) questionnaires. A literature review was done to compare the results with financial toxicity and mental health in cancer patients from the pre‐pandemic era.

          Results

          A total of 79 oral cancer survivors were included in the study, predominantly males (M: F = 10:1). The age ranged from 26 to 75 years (The median age is 49). The full‐time employment dropped from 83.5% in the pre‐treatment period to 21.5% post‐treatment. Depression was observed in 58.2% and anxiety in 72.2%. Unemployed survivors were observed to have more depression (OR = 1.3, 95% confidence interval (CI) = 0.3–5.4, p = 0.6), anxiety (OR = 3.5, 95% CI = 0.3–21.2, p = 0.1) and stress (OR = 1.6, 95% CI = 0.3–6.6, p = 0.5) than rest of the cohort. On univariate analysis, unemployed survivors ( M = 11.8 ± 3.8, p = 0.01) had significantly poorer financial toxicity scores. Survivors with depression ( M = 16.4 ± 7.1, p = 0.06) and stress ( M = 14.4 ± 6.8, p = 0.002) had poor financial toxicity scores. On multifactorial analysis of variance, current employment ( p = 0.04) and treatment modality ( p = 0.05) were significant factors impacting the financial toxicity.

          Conclusion

          There is a trend towards increased incidence of depression, anxiety, and stress among oral cancer survivors compared to the literature from the pre‐COVID era. There is significant financial toxicity among either unemployed or part‐time workers. This calls for urgent public/government intervention to prevent the long‐term impact of financial toxicity on survival and quality of life.

          Related collections

          Most cited references38

          • Record: found
          • Abstract: found
          • Article: not found

          The financial burden and distress of patients with cancer: Understanding and stepping-up action on the financial toxicity of cancer treatment.

          "Financial toxicity" has now become a familiar term used in the discussion of cancer drugs, and it is gaining traction in the literature given the high price of newer classes of therapies. However, as a phenomenon in the contemporary treatment and care of people with cancer, financial toxicity is not fully understood, with the discussion on mitigation mainly geared toward interventions at the health system level. Although important, health policy prescriptions take time before their intended results manifest, if they are implemented at all. They require corresponding strategies at the individual patient level. In this review, the authors discuss the nature of financial toxicity, defined as the objective financial burden and subjective financial distress of patients with cancer, as a result of treatments using innovative drugs and concomitant health services. They discuss coping with financial toxicity by patients and how maladaptive coping leads to poor health and nonhealth outcomes. They cover management strategies for oncologists, including having the difficult and urgent conversation about the cost and value of cancer treatment, availability of and access to resources, and assessment of financial toxicity as part of supportive care in the provision of comprehensive cancer care. CA Cancer J Clin 2018;68:153-165. © 2018 American Cancer Society.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Financial Hardship Associated With Cancer in the United States: Findings From a Population-Based Sample of Adult Cancer Survivors.

            To estimate the prevalence of financial hardship associated with cancer in the United States and identify characteristics of cancer survivors associated with financial hardship.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Financial Burdens of Cancer Treatment: A Systematic Review of Risk Factors and Outcomes

              Patients with cancer experience financial toxicity from the costs of treatment, as well as material and psychologic stress related to this burden. A synthesized understanding of predictors and outcomes of the financial burdens associated with cancer care is needed to underpin strategic responses in oncology care. This study systematically reviewed risk factors and outcomes associated with financial burdens related to cancer treatment. MEDLINE, Embase, PubMed, PsychINFO, and the Cochrane Library were searched from study inception through June 2018, and reference lists were scanned from studies of patient-level predictors and outcomes of financial burdens in US patients with cancer (aged ≥18 years). Two reviewers conducted screening, abstraction, and quality assessment. Variables associated with financial burdens were synthesized. When possible, pooled estimates of associations were calculated using random-effects models. A total of 74 observational studies of financial burdens in 598,751 patients with cancer were identified, among which 49% of patients reported material or psychologic financial burdens (95% CI, 41%−56%). Socioeconomic predictors of worse financial burdens with treatment were lack of health insurance, lower income, unemployment, and younger age at cancer diagnosis. Compared with patients with health insurance, those who were uninsured demonstrated twice the odds of financial burdens (pooled odds ratio [OR], 2.09; 95% CI, 1.33–3.30). Financial burdens were most severe early in cancer treatment, did not differ by disease site, and were associated with worse health-related quality of life (HRQoL) and nearly twice the odds of cancer medication nonadherence (pooled OR, 1.70; 95% CI, 1.13–2.56). Only a single study demonstrated an association with increased mortality. Studies assessing the comparative effectiveness of interventions to mitigate financial burdens in patients with cancer were lacking. Evidence showed that financial burdens are common, disproportionately impacting younger and socioeconomically disadvantaged patients with cancer, across disease sites, and are associated with worse treatment adherence and HRQoL. Available evidence helped identify vulnerable patients needing oncology provider engagement and response, but evidence is critically needed on the effectiveness of interventions designed to mitigate financial burden and impact.
                Bookmark

                Author and article information

                Contributors
                manumalhotrallrm@gmail.com
                Journal
                Psychooncology
                Psychooncology
                10.1002/(ISSN)1099-1611
                PON
                Psycho-Oncology
                John Wiley and Sons Inc. (Hoboken )
                1057-9249
                1099-1611
                14 September 2022
                14 September 2022
                : 10.1002/pon.6030
                Affiliations
                [ 1 ] Department of ENT and Head Neck Surgery All India Institute of Medical Sciences Rishikesh India
                [ 2 ] Department of Surgical Oncology Shri Guru Ram Rai Institute of Medical & Health Sciences Dehradun India
                [ 3 ] Jawaharlal Nehru Cancer Hospital & Research Centre Bhopal India
                [ 4 ] Department of Surgical Oncology All India Institute of Medical Sciences Jodhpur India
                Author notes
                [*] [* ] Correspondence

                Manu Malhotra, Department of ENT and Head Neck Surgery, All India Institute of Medical Sciences, Rishikesh, India.

                Email: manumalhotrallrm@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-4696-3139
                Article
                PON6030
                10.1002/pon.6030
                9539264
                36073555
                c3c831b2-2a81-4dcb-8fcf-f9642031218d
                © 2022 John Wiley & Sons Ltd.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 18 July 2022
                : 12 February 2022
                : 29 August 2022
                Page count
                Figures: 0, Tables: 4, Pages: 10, Words: 5873
                Categories
                Original Article
                Original Article
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.0 mode:remove_FC converted:07.10.2022

                anxiety,cancer,cancer survivors,covid 19 pandemic,depression,financial toxicity,mental health,mental well‐being,oncology,oral cancer,stress

                Comments

                Comment on this article