Inequalities in Financial Distress, Symptoms, and Quality of Life Among Patients with Advanced Cancer in France and the U.S

Background Financial distress (FD) is common among patients with advanced cancer. Our purpose was to compare the frequency and intensity of FD and its associations with symptom distress and quality of life (QOL) in these patients in France and the U.S. Materials and Methods In this secondary analysi...

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Veröffentlicht in:The oncologist (Dayton, Ohio) Ohio), 2019-08, Vol.24 (8), p.1121-1127
Hauptverfasser: Barbaret, Cécile, Delgado‐Guay, Marvin O., Sanchez, Stéphane, Brosse, Christelle, Ruer, Murielle, Rhondali, Wadih, Monsarrat, Léa, Michaud, Patrick, Schott, Anne Marie, Bruera, Eduardo, Filbet, Marilène
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container_issue 8
container_start_page 1121
container_title The oncologist (Dayton, Ohio)
container_volume 24
creator Barbaret, Cécile
Delgado‐Guay, Marvin O.
Sanchez, Stéphane
Brosse, Christelle
Ruer, Murielle
Rhondali, Wadih
Monsarrat, Léa
Michaud, Patrick
Schott, Anne Marie
Bruera, Eduardo
Filbet, Marilène
description Background Financial distress (FD) is common among patients with advanced cancer. Our purpose was to compare the frequency and intensity of FD and its associations with symptom distress and quality of life (QOL) in these patients in France and the U.S. Materials and Methods In this secondary analysis of two cross‐sectional studies, we assessed data on 292 patients who received cancer care at a public hospital or a comprehensive cancer center in France (143 patients) or the U.S. (149 patients). Outpatients and hospitalized patients over 18 years of age with advanced lung or breast or colorectal or prostate cancer were included. Diagnosed cognitive disorder was considered a noninclusion criterion. Advanced cancer included relapse or metastasis or locally advanced cancer or at least a second‐line chemotherapy regimen. Patients self‐rated FD and assessed symptoms, psychosocial distress, and QOL on validated questionnaires. Results The average patient age was 59 years, and 144 (49%) were female. FD and high intensity were reported more frequently in U.S. patients than in French (respectively 129 [88%] vs. 74 [52%], p 
doi_str_mv 10.1634/theoncologist.2018-0353
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Our purpose was to compare the frequency and intensity of FD and its associations with symptom distress and quality of life (QOL) in these patients in France and the U.S. Materials and Methods In this secondary analysis of two cross‐sectional studies, we assessed data on 292 patients who received cancer care at a public hospital or a comprehensive cancer center in France (143 patients) or the U.S. (149 patients). Outpatients and hospitalized patients over 18 years of age with advanced lung or breast or colorectal or prostate cancer were included. Diagnosed cognitive disorder was considered a noninclusion criterion. Advanced cancer included relapse or metastasis or locally advanced cancer or at least a second‐line chemotherapy regimen. Patients self‐rated FD and assessed symptoms, psychosocial distress, and QOL on validated questionnaires. Results The average patient age was 59 years, and 144 (49%) were female. FD and high intensity were reported more frequently in U.S. patients than in French (respectively 129 [88%] vs. 74 [52%], p &lt; .001; 100 [98%] vs. 48 [34%], p &lt; .001,). QOL was rated higher by the U.S. patients than by the French (69 [SD, 18] vs. 63 [SD, 18], p = .003). French patients had more psychological symptoms such as anxiety (8 [SD, 4] vs. 6 [SD, 5], p = .008). Associations were found between FD and U.S. residence, FD and single status (0.907, p = .023), and FD and metastasis (1.538, p = .036). In contrast, negative associations were found between FD and older age (−0.052, p = .003) and FD and France residence (−3.376, p = .001). Conclusion Regardless of health care system, FD is frequent in patients with advanced cancer. U.S. patients were more likely to have FD than French patients but reported better QOL. Further research should focus on factors contributing to FD and opportunities for remediation. Implications for Practice Suffering is experienced in any component of the lives of patients with a life‐threatening illness. Financial distress (FD) is one of the least explored cancer‐related symptoms, and there are limited studies describing its impact on this frail population. This study highlights the high frequency and severity of FD in patients with advanced cancer in the U.S. and France as well as its impact on their physical and emotional symptoms and their quality of life in these different health care systems. It is necessary for all health care providers to explore and evaluate the presence of FD in patients living with life‐threatening illnesses. Cancer patients and their families often must make financial adjustments related to the costs of treatment. This articles explores the effects of financial distress on overall quality of life, focusing on the differences in results in patients treated within the different health care systems of the U.S. and France.</description><identifier>ISSN: 1083-7159</identifier><identifier>EISSN: 1549-490X</identifier><identifier>DOI: 10.1634/theoncologist.2018-0353</identifier><identifier>PMID: 30877191</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley &amp; Sons, Inc</publisher><subject>Advanced cancer ; Aged ; Cohort Studies ; Cost of Illness ; Cross-Cultural Comparison ; Cross-Sectional Studies ; Female ; Financial distress ; France ; Health Status Disparities ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasms - complications ; Neoplasms - economics ; Neoplasms - pathology ; Neoplasms - psychology ; Palliative care ; Quality of Life ; Self Report - statistics &amp; numerical data ; Socioeconomic Factors ; Symptom distress ; Symptom Management and Supportive Care ; United States</subject><ispartof>The oncologist (Dayton, Ohio), 2019-08, Vol.24 (8), p.1121-1127</ispartof><rights>AlphaMed Press 2019</rights><rights>AlphaMed Press 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4725-8f7fe4beaa7beb9658bed57c14a9dd02753513a3ec64ccad8894188c52138b1d3</citedby><cites>FETCH-LOGICAL-c4725-8f7fe4beaa7beb9658bed57c14a9dd02753513a3ec64ccad8894188c52138b1d3</cites><orcidid>0000-0001-7144-7115</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693692/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693692/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,1412,27905,27906,45555,45556,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30877191$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barbaret, Cécile</creatorcontrib><creatorcontrib>Delgado‐Guay, Marvin O.</creatorcontrib><creatorcontrib>Sanchez, Stéphane</creatorcontrib><creatorcontrib>Brosse, Christelle</creatorcontrib><creatorcontrib>Ruer, Murielle</creatorcontrib><creatorcontrib>Rhondali, Wadih</creatorcontrib><creatorcontrib>Monsarrat, Léa</creatorcontrib><creatorcontrib>Michaud, Patrick</creatorcontrib><creatorcontrib>Schott, Anne Marie</creatorcontrib><creatorcontrib>Bruera, Eduardo</creatorcontrib><creatorcontrib>Filbet, Marilène</creatorcontrib><title>Inequalities in Financial Distress, Symptoms, and Quality of Life Among Patients with Advanced Cancer in France and the U.S</title><title>The oncologist (Dayton, Ohio)</title><addtitle>Oncologist</addtitle><description>Background Financial distress (FD) is common among patients with advanced cancer. Our purpose was to compare the frequency and intensity of FD and its associations with symptom distress and quality of life (QOL) in these patients in France and the U.S. Materials and Methods In this secondary analysis of two cross‐sectional studies, we assessed data on 292 patients who received cancer care at a public hospital or a comprehensive cancer center in France (143 patients) or the U.S. (149 patients). Outpatients and hospitalized patients over 18 years of age with advanced lung or breast or colorectal or prostate cancer were included. Diagnosed cognitive disorder was considered a noninclusion criterion. Advanced cancer included relapse or metastasis or locally advanced cancer or at least a second‐line chemotherapy regimen. Patients self‐rated FD and assessed symptoms, psychosocial distress, and QOL on validated questionnaires. Results The average patient age was 59 years, and 144 (49%) were female. FD and high intensity were reported more frequently in U.S. patients than in French (respectively 129 [88%] vs. 74 [52%], p &lt; .001; 100 [98%] vs. 48 [34%], p &lt; .001,). QOL was rated higher by the U.S. patients than by the French (69 [SD, 18] vs. 63 [SD, 18], p = .003). French patients had more psychological symptoms such as anxiety (8 [SD, 4] vs. 6 [SD, 5], p = .008). Associations were found between FD and U.S. residence, FD and single status (0.907, p = .023), and FD and metastasis (1.538, p = .036). In contrast, negative associations were found between FD and older age (−0.052, p = .003) and FD and France residence (−3.376, p = .001). Conclusion Regardless of health care system, FD is frequent in patients with advanced cancer. U.S. patients were more likely to have FD than French patients but reported better QOL. Further research should focus on factors contributing to FD and opportunities for remediation. Implications for Practice Suffering is experienced in any component of the lives of patients with a life‐threatening illness. Financial distress (FD) is one of the least explored cancer‐related symptoms, and there are limited studies describing its impact on this frail population. This study highlights the high frequency and severity of FD in patients with advanced cancer in the U.S. and France as well as its impact on their physical and emotional symptoms and their quality of life in these different health care systems. It is necessary for all health care providers to explore and evaluate the presence of FD in patients living with life‐threatening illnesses. Cancer patients and their families often must make financial adjustments related to the costs of treatment. This articles explores the effects of financial distress on overall quality of life, focusing on the differences in results in patients treated within the different health care systems of the U.S. and France.</description><subject>Advanced cancer</subject><subject>Aged</subject><subject>Cohort Studies</subject><subject>Cost of Illness</subject><subject>Cross-Cultural Comparison</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Financial distress</subject><subject>France</subject><subject>Health Status Disparities</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - economics</subject><subject>Neoplasms - pathology</subject><subject>Neoplasms - psychology</subject><subject>Palliative care</subject><subject>Quality of Life</subject><subject>Self Report - statistics &amp; numerical data</subject><subject>Socioeconomic Factors</subject><subject>Symptom distress</subject><subject>Symptom Management and Supportive Care</subject><subject>United States</subject><issn>1083-7159</issn><issn>1549-490X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkVFv0zAUhSMEYmPwF8CPPJBix3FsvyBVHRuTKgoak3izHPumNUrszk43Vfz5Od0Y7I2neySf-_nYpyjeETwjDa0_jhsI3oQ-rF0aZxUmosSU0WfFMWG1LGuJfz7PGgtacsLkUfEqpV8YZ0mrl8URxYJzIslx8fvCw_VO9250kJDz6Mx57Y3TPTrN6AgpfUCX-2E7hiEr7S36frDvUejQ0nWA5kPwa_RNZ4IfE7p14wbN7U2mgEWLacQDOE7yQMjp0dXs8nXxotN9gjcP86S4Ovv8Y_GlXK7OLxbzZWlqXrFSdLyDugWteQutbJhowTJuSK2ltbjijDJCNQXT1MZoK4SsiRCGVYSKllh6Uny652537QDW5JhR92ob3aDjXgXt1NMT7zZqHW5U00jayCoD3j8AYrjeQRrV4JKBvtcewi6pikhKGikpzlZ-bzUxpBShe7yGYDVVp55Up6bq1FRd3nz7b8rHvT9d_X3Greth_79ctfq6WJFK5F-6A0hHsBg</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Barbaret, Cécile</creator><creator>Delgado‐Guay, Marvin O.</creator><creator>Sanchez, Stéphane</creator><creator>Brosse, Christelle</creator><creator>Ruer, Murielle</creator><creator>Rhondali, Wadih</creator><creator>Monsarrat, Léa</creator><creator>Michaud, Patrick</creator><creator>Schott, Anne Marie</creator><creator>Bruera, Eduardo</creator><creator>Filbet, Marilène</creator><general>John Wiley &amp; Sons, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7144-7115</orcidid></search><sort><creationdate>201908</creationdate><title>Inequalities in Financial Distress, Symptoms, and Quality of Life Among Patients with Advanced Cancer in France and the U.S</title><author>Barbaret, Cécile ; Delgado‐Guay, Marvin O. ; Sanchez, Stéphane ; Brosse, Christelle ; Ruer, Murielle ; Rhondali, Wadih ; Monsarrat, Léa ; Michaud, Patrick ; Schott, Anne Marie ; Bruera, Eduardo ; Filbet, Marilène</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4725-8f7fe4beaa7beb9658bed57c14a9dd02753513a3ec64ccad8894188c52138b1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Advanced cancer</topic><topic>Aged</topic><topic>Cohort Studies</topic><topic>Cost of Illness</topic><topic>Cross-Cultural Comparison</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Financial distress</topic><topic>France</topic><topic>Health Status Disparities</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - economics</topic><topic>Neoplasms - pathology</topic><topic>Neoplasms - psychology</topic><topic>Palliative care</topic><topic>Quality of Life</topic><topic>Self Report - statistics &amp; numerical data</topic><topic>Socioeconomic Factors</topic><topic>Symptom distress</topic><topic>Symptom Management and Supportive Care</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barbaret, Cécile</creatorcontrib><creatorcontrib>Delgado‐Guay, Marvin O.</creatorcontrib><creatorcontrib>Sanchez, Stéphane</creatorcontrib><creatorcontrib>Brosse, Christelle</creatorcontrib><creatorcontrib>Ruer, Murielle</creatorcontrib><creatorcontrib>Rhondali, Wadih</creatorcontrib><creatorcontrib>Monsarrat, Léa</creatorcontrib><creatorcontrib>Michaud, Patrick</creatorcontrib><creatorcontrib>Schott, Anne Marie</creatorcontrib><creatorcontrib>Bruera, Eduardo</creatorcontrib><creatorcontrib>Filbet, Marilène</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The oncologist (Dayton, Ohio)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barbaret, Cécile</au><au>Delgado‐Guay, Marvin O.</au><au>Sanchez, Stéphane</au><au>Brosse, Christelle</au><au>Ruer, Murielle</au><au>Rhondali, Wadih</au><au>Monsarrat, Léa</au><au>Michaud, Patrick</au><au>Schott, Anne Marie</au><au>Bruera, Eduardo</au><au>Filbet, Marilène</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inequalities in Financial Distress, Symptoms, and Quality of Life Among Patients with Advanced Cancer in France and the U.S</atitle><jtitle>The oncologist (Dayton, Ohio)</jtitle><addtitle>Oncologist</addtitle><date>2019-08</date><risdate>2019</risdate><volume>24</volume><issue>8</issue><spage>1121</spage><epage>1127</epage><pages>1121-1127</pages><issn>1083-7159</issn><eissn>1549-490X</eissn><abstract>Background Financial distress (FD) is common among patients with advanced cancer. Our purpose was to compare the frequency and intensity of FD and its associations with symptom distress and quality of life (QOL) in these patients in France and the U.S. Materials and Methods In this secondary analysis of two cross‐sectional studies, we assessed data on 292 patients who received cancer care at a public hospital or a comprehensive cancer center in France (143 patients) or the U.S. (149 patients). Outpatients and hospitalized patients over 18 years of age with advanced lung or breast or colorectal or prostate cancer were included. Diagnosed cognitive disorder was considered a noninclusion criterion. Advanced cancer included relapse or metastasis or locally advanced cancer or at least a second‐line chemotherapy regimen. Patients self‐rated FD and assessed symptoms, psychosocial distress, and QOL on validated questionnaires. Results The average patient age was 59 years, and 144 (49%) were female. FD and high intensity were reported more frequently in U.S. patients than in French (respectively 129 [88%] vs. 74 [52%], p &lt; .001; 100 [98%] vs. 48 [34%], p &lt; .001,). QOL was rated higher by the U.S. patients than by the French (69 [SD, 18] vs. 63 [SD, 18], p = .003). French patients had more psychological symptoms such as anxiety (8 [SD, 4] vs. 6 [SD, 5], p = .008). Associations were found between FD and U.S. residence, FD and single status (0.907, p = .023), and FD and metastasis (1.538, p = .036). In contrast, negative associations were found between FD and older age (−0.052, p = .003) and FD and France residence (−3.376, p = .001). Conclusion Regardless of health care system, FD is frequent in patients with advanced cancer. U.S. patients were more likely to have FD than French patients but reported better QOL. Further research should focus on factors contributing to FD and opportunities for remediation. Implications for Practice Suffering is experienced in any component of the lives of patients with a life‐threatening illness. Financial distress (FD) is one of the least explored cancer‐related symptoms, and there are limited studies describing its impact on this frail population. This study highlights the high frequency and severity of FD in patients with advanced cancer in the U.S. and France as well as its impact on their physical and emotional symptoms and their quality of life in these different health care systems. It is necessary for all health care providers to explore and evaluate the presence of FD in patients living with life‐threatening illnesses. Cancer patients and their families often must make financial adjustments related to the costs of treatment. This articles explores the effects of financial distress on overall quality of life, focusing on the differences in results in patients treated within the different health care systems of the U.S. and France.</abstract><cop>Hoboken, USA</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>30877191</pmid><doi>10.1634/theoncologist.2018-0353</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7144-7115</orcidid><oa>free_for_read</oa></addata></record>
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subjects Advanced cancer
Aged
Cohort Studies
Cost of Illness
Cross-Cultural Comparison
Cross-Sectional Studies
Female
Financial distress
France
Health Status Disparities
Humans
Male
Middle Aged
Neoplasm Staging
Neoplasms - complications
Neoplasms - economics
Neoplasms - pathology
Neoplasms - psychology
Palliative care
Quality of Life
Self Report - statistics & numerical data
Socioeconomic Factors
Symptom distress
Symptom Management and Supportive Care
United States
title Inequalities in Financial Distress, Symptoms, and Quality of Life Among Patients with Advanced Cancer in France and the U.S
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