Nursing Department, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
The Department of Chemotherapy, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
BMC Cancer. 2023 Feb 10;23(1):140. doi: 10.1186/s12885-023-10580-4.
Cancer patients with financial toxicity experience psychological distress and often miss medical appointments and quit treatments early, which could be a barrier to the effective management of oral chemotherapy drugs at home. This study explores whether financial toxicity predicts symptoms and unplanned healthcare utilization among cancer patients taking oral chemotherapy at home, which will contribute to the safe management of oral chemotherapy.
Data in this study was from a prospective observational study, which was conducted between October 2018 and December 2019. 151 patients completed the Comprehensive Score for Financial Toxicity at discharge and completed the MD Anderson Symptom Inventory and unplanned healthcare utilization questionnaires after finishing one cycle of oral chemotherapy at home. Regression analyses were conducted to explore the associations of financial toxicity with symptoms and unplanned healthcare utilization.
Among 151participants, 88.08% reported severe or moderate financial toxicity, 43.05% reported symptom interference, and 31.79% reported unplanned healthcare utilization while taking oral chemotherapy at home. Patients between the age of 45-60y (p = 0.042) have higher financial toxicity, while those living in urban areas (p = 0.016) have lower financial toxicity. Patients with worse financial toxicity suffered increased symptoms of fatigue, emotional distress, disturbed sleep, and lack of appetite. Consequently, their mood and personal relation with other significant suffered. However, no statistical differences in unplanned healthcare utilization were found among patients with different levels of financial toxicity.
Middle-aged adults and those living in suburban or rural areas experienced worse financial toxicity than other groups. Patients with worse financial toxicity experienced more severe psychological symptoms (e.g., fatigue, distress, disturbed sleep, and lack of appetite) and affective interference (e.g., mood and relations with others). Identifying at-risk patients is necessary to offer tailored support for psychological symptom management.
经济毒性会导致癌症患者出现心理困扰，经常错过医疗预约并提前终止治疗，这可能会成为有效管理居家口服化疗药物的障碍。本研究旨在探讨经济毒性是否可预测癌症患者居家接受口服化疗时的症状和非计划性医疗保健利用情况，这将有助于安全管理口服化疗。
本研究的数据来自于一项前瞻性观察性研究，该研究于 2018 年 10 月至 2019 年 12 月进行。151 名患者在出院时完成了全面经济毒性评分，在完成一个周期的居家口服化疗后完成了 MD 安德森症状量表和非计划性医疗保健利用问卷。回归分析用于探索经济毒性与症状和非计划性医疗保健利用之间的关系。
在 151 名参与者中，88.08%报告了严重或中度经济毒性，43.05%报告了症状干扰，31.79%报告了居家口服化疗时的非计划性医疗保健利用。45-60 岁的患者（p=0.042）经济毒性较高，而居住在城市地区的患者（p=0.016）经济毒性较低。经济毒性较差的患者出现疲劳、情绪困扰、睡眠障碍和食欲不振等症状加重。因此，他们的情绪和与其他重要人物的关系受到影响。然而，在不同经济毒性水平的患者之间，非计划性医疗保健利用没有统计学差异。
中年患者和居住在郊区或农村地区的患者比其他群体经历了更严重的经济毒性。经济毒性较差的患者经历了更严重的心理症状（如疲劳、困扰、睡眠障碍和食欲不振）和情感干扰（如情绪和与他人的关系）。有必要识别高风险患者，为其提供心理症状管理的定制支持。
