Dados do Trabalho

Título

THE IMPACT OF CANCER TREATMENT “OUT-OF-POCKET” COSTS ON THE MENTAL HEALTH OF CHEMOTHERAPY PATIENTS: A COMPARATIVE STUD

Introdução

Anxiety and depression represent very prevalent comorbidities in cancer patients, especially when under stressors. Although cancer treatment is funded by the Brazilian National Health System (SUS), the economic burden also relies on patients through indirect or “out-of-pocket” costs. Our study aims to assess the impact of those costs on the patients' mental health.

Objetivo

To analyse the impact of indirects costs of cancer treatment on the levels of depression, anxiety and stress.

Método

Observational, cross-sectional and analytical study carried out in 2021. Patients undergoing chemotherapy were selected from: a tertiary hospital linked to SUS; and research protocols from a study and research center. To assess indirect costs, we used a socioeconomic questionnaire to identify costs and time spent by patients on cancer treatment. The primary outcome was the prevalence of depression and anxiety documented by the Hospital Anxiety and Depression Scale (HADS) questionnaire and the prevalence of stress using the Stress Thermometer. Univariate analysis was performed using the T-test or Mann-Whitney and the correlations by the Spearman test, depending on the normality assessed by the Shapiro-Wilk test. Study approved by the Research Ethics Committee (CAAE 30524420.3.0000.0082).

Resultado

195 patients were included, 165 (84.6%) from the SUS group. 61% were female and the mean age of patients was 57 years. The median of global indirect costs was 453.80 Brazilian reais. According to HADS, 62.1% of patients have possible or probable depression/anxiety. There was no correlation between global indirect costs and levels of depression and anxiety. However, stratifying by time-value variables, there was a negative correlation between telephone costs and HADS (rho = -0.140; P = 0.049); and positive correlations between medication costs (rho = 0.140; P = 0.05) and time to purchase medications (rho = 0.157; P = 0.029) with HADS.

Conclusão

Our study found an important prevalence regarding depression and anxiety in cancer patients. Although global indirect costs are not directly correlated with mental health, stratification by specific costs seems to impact levels of anxiety, depression and stress, and may lead public health strategies. However, the global indirect costs of cancer treatment did not correlate with levels of depression, anxiety or stress.

Palavras-chave

Neoplasms; Costs; Depression.