Gridelli Cesare, Ferrara Carmine, Guerriero Ciro, Palazzo Salvatore, Grasso Giuseppe, Pavese Ida, Satta Francesco, Bajetta Emilio, Cortinovis Diego, Barbieri Fausto, Gebbia Vittorio, Grossi Francesco, Novello Silvia, Baldini Editta, Gasparini Giampietro, Latino Walter, Durante Emilia, Giustini Lucio, Negrini Cristina
Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy.
J Thorac Oncol. 2007 Jun;2(6):475-80. doi: 10.1097/01.JTO.0000275342.47584.f3.
This study's aim was to assess economic data regarding the home assistance burden for advanced non-small cell lung cancer (NSCLC) patients in Italy.
One hundred four NSCLC patients in second-line chemotherapy (2LC) or in supportive therapy (ST) were enrolled in 18 Italian oncology departments and were observed for 3 months. The main caregiver's workload was assessed monthly by a task scale; other caregivers' activities were also registered. Eastern Cooperative Oncology Group performance status was assessed by physicians, and patients completed the Lung Cancer Symptoms (LCS) subscale. Formal caregiving time was valued according to market prices; informal caregiving hours were valued using the wage rate for an equivalent service. Covariance analysis was performed to check for influential factors in assistance costs.
The mean age of the total sample was 65.5 years, and prevalence of males was over 80%. In over 70% of cases, the principal caregiver was patient's spouse, living with the patient and not working. Principal caregiver support was the main cost item: 2.368 euros in 2LC and 2.805 euros in ST, representing 74% of total trimonthly assistance costs. Regression analysis showed a positive correlation between the severity of symptoms and the costs of assistance. The caregiving burden was higher in patients with bone and/or cerebral metastases; other metastasis sites seemed to have no impact on assistance costs.
Considering quality of life as the ultimate health outcome, clinicians are challenged to contribute to a research and policy agenda that holds burden of care in due consideration.
本研究旨在评估意大利晚期非小细胞肺癌（NSCLC）患者家庭护理负担的经济数据。
104例接受二线化疗（2LC）或支持治疗（ST）的NSCLC患者被纳入意大利18个肿瘤科室，并接受为期3个月的观察。主要照料者的工作量每月通过任务量表进行评估；其他照料者的活动也进行了记录。由医生评估东部肿瘤协作组（ECOG）体能状态，患者完成肺癌症状（LCS）子量表。正式护理时间按市场价格估值；非正式护理时间按同等服务的工资率估值。进行协方差分析以检查影响护理成本的因素。
总样本的平均年龄为65.5岁，男性患病率超过80%。在超过70%的病例中，主要照料者是患者的配偶，与患者同住且无工作。主要照料者的支持是主要成本项目：2LC组为2368欧元，ST组为2805欧元，占每三个月总护理成本的74%。回归分析显示症状严重程度与护理成本之间呈正相关。骨和/或脑转移患者的护理负担更高；其他转移部位似乎对护理成本没有影响。
将生活质量视为最终的健康结果，临床医生面临挑战，需要为充分考虑护理负担的研究和政策议程做出贡献。
