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美国胰腺癌患者的姑息治疗与心理健康:服务利用与健康结局考察

Palliative Care and Mental Health among Pancreatic Cancer Patients in the United States: An Examination of Service Utilization and Health Outcomes.

作者信息

Subramaniam Divya S, Zhang Zidong, Timmer Zachary, DeMarco Elisabeth C, Poirier Michael P, Hinyard Leslie J

机构信息

Department of Health and Clinical Outcomes Research, Advanced HEAlth Data (AHEAD) Institute, Saint Louis University School of Medicine, St. Louis, MO 63108, USA.

出版信息

Healthcare (Basel). 2024 Apr 16;12(8):842. doi: 10.3390/healthcare12080842.

Abstract

INTRODUCTION

Palliative care (PC) utilization remains low among pancreatic cancer patients. This study explores the association of PC with mental health service and pharmacotherapy utilization among pancreatic cancer patients.

METHODS

Retrospective analysis was conducted on a sample of patients in the United States with newly diagnosed pancreatic cancer using Electronic Health Record data from Optum's Integrated Claims-Clinical data set. Subsequent diagnoses of anxiety and depression and PC consultation encounters were determined using ICD-9/10 codes. Adjusted associations of mental health treatments with PC and patient characteristics were quantified using multiple logistic regression.

RESULTS

Among newly diagnosed pancreatic cancer patients ( = 4029), those with PC consultations exhibited a higher prevalence of anxiety (33.9% vs. 22.8%) and depression (36.2% vs. 23.2%). Mental health service use and pharmacotherapy varied, with the highest utilization among patients having both anxiety and depression. Treatment pattern was also influenced by age (aOR 1.832 for age <55 vs. 65-70 years). Notably, PC consultations showed no significant effect on the likelihood of documented treatment.

DISCUSSION

Our study emphasizes underutilization of PC and MH treatment for pancreatic cancer patients. These findings imply a crucial need for further investigation into palliative care's role in addressing mental health concerns among pancreatic cancer patients.

摘要

引言

胰腺癌患者对姑息治疗(PC)的利用率仍然较低。本研究探讨了胰腺癌患者中姑息治疗与心理健康服务及药物治疗利用率之间的关联。

方法

利用Optum综合索赔-临床数据集的电子健康记录数据,对美国新诊断为胰腺癌的患者样本进行回顾性分析。使用ICD-9/10编码确定后续的焦虑和抑郁诊断以及姑息治疗咨询情况。使用多元逻辑回归对心理健康治疗与姑息治疗及患者特征之间的校正关联进行量化。

结果

在新诊断的胰腺癌患者(n = 4029)中,接受姑息治疗咨询的患者焦虑患病率较高(33.9%对22.8%),抑郁患病率也较高(36.2%对23.2%)。心理健康服务的使用和药物治疗情况各不相同,焦虑和抑郁兼具的患者利用率最高。治疗模式也受年龄影响(年龄<55岁与65 - 70岁相比,调整后比值比为1.832)。值得注意的是,姑息治疗咨询对记录在案的治疗可能性没有显著影响。

讨论

我们的研究强调了胰腺癌患者对姑息治疗和心理健康治疗的利用不足。这些发现意味着迫切需要进一步研究姑息治疗在解决胰腺癌患者心理健康问题方面的作用。

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