More competent informal caregivers reduce advanced cancer patients' unplanned healthcare use and costs.

Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE

Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-

Caregivers*/psychology ; Caregivers*/economics ; Neoplasms*/therapy ; Neoplasms*/economics ; Health Care Costs*; Humans ; Female ; Male ; Middle Aged ; Prospective Studies ; Aged ; Patient Acceptance of Health Care ; Surveys and Questionnaires ; Adult

Background: Patients with metastatic cancer experience high healthcare use and costs, most of which are unplanned. We aimed to assess whether patients with more competent informal caregivers have lower unplanned healthcare use and costs.
Methods: This study used data from a prospective cohort of patients with solid metastatic cancer. Patients and their informal family caregivers were surveyed every 3 months until patients' death. Patients' unplanned healthcare use/costs were examined through hospital records. Caregivers responded to the 4-item Caregiver Competence Scale. First, in a deceased subsample of patients and their caregivers, we used patients' last 2 years of data (226 dyads) to assess the association between caregivers' competency (independent variable) and patients' unplanned healthcare use/costs (outcomes). Next, in a prospective sample of patient-caregiver dyads (up to 15 surveys), we assessed whether patients' functional well-being and psychological distress moderated the association between caregivers' competency and unplanned healthcare use/costs (311 dyads).
Results: In the deceased subsample, during last 2 years of patients' life, caregivers' higher competency lowered the odds of patients' unplanned healthcare use [OR (CI) = 0.86 (0.75, 0.98), p = 0.03], and was associated with a significant reduction in unplanned healthcare costs [Coeff (CI) = -0.19 (-0.36, -0.01), p = 0.03]. In the prospective sample, patients' functional well-being and psychological distress moderated the association between caregivers' competency and patients' unplanned healthcare use/costs.
Conclusion: With deterioration in patients' condition and an increase in caregiving demands, improving caregivers' competency can reduce patients' unplanned healthcare use and costs. This should be further tested in future trials.
(© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

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2015-SM-0003 Singapore Millennium Foundation; LCPC-IN14-0003 Lien Centre for Palliative Care

Keywords: advanced cancer; cancer caregivers; caregiver competency; unplanned healthcare costs; unplanned healthcare use

Date Created: 20240614 Date Completed: 20240614 Latest Revision: 20240618

20240618

PMC11176569

10.1002/cam4.7366

38872395