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Association of Employment Status With Symptom Burden and Health-Related Quality of Life in People Living With Primary CNS Tumors.
Leeper, Heather E; Vera, Elizabeth; Christ, Alexa; Acquaye, Alvina; Briceno, Nicole; Choi, Anna; Grajkowska, Ewa; Jammula, Varna; Levine, Jason; Lindsley, Matthew; Reyes, Jennifer; Roche, Kayla N; Rogers, James L; Timmer, Michael; Boris, Lisa; Burton, Eric; Lollo, Nicole; Panzer, Marissa; Penas-Prado, Marta; Pillai, Valentina; Polskin, Lily; Theeler, Brett J; Wu, Jing; Gilbert, Mark R; Armstrong, Terri S.
Afiliación
  • Leeper HE; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Vera E; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Christ A; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Acquaye A; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Briceno N; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Choi A; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Grajkowska E; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Jammula V; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Levine J; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Lindsley M; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Reyes J; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Roche KN; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Rogers JL; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Timmer M; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Boris L; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Burton E; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Lollo N; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Panzer M; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Penas-Prado M; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Pillai V; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Polskin L; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Theeler BJ; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Wu J; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Gilbert MR; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
  • Armstrong TS; From the Neuro-Oncology Branch (H.E.L., E.V., A. Christ, A.A., N.B., A. Choi, E.G., V.J., M.L., J.R., K.N.R., J.L.R., M.T., E.B., M.P.-P., V.P., L.P., B.J.T., J.W., M.R.G., T.S.A.), and Office of Information Technology (J.L.), Center for Cancer Research, National Cancer Institute, NIH, Bethesda; Lei
Neurology ; 100(16): e1723-e1736, 2023 04 18.
Article en En | MEDLINE | ID: mdl-36754634
BACKGROUND AND OBJECTIVES: Financial toxicity significantly affects many patients, especially cancer survivors. We evaluated the association of unemployment as a major contributor to financial toxicity with patient-reported outcomes (PROs) assessing multiple illness experience domains in a primary CNS tumor (PCNST) cohort. METHODS: Patient and disease characteristics and PROs measuring symptom burden, interference, psychologic distress, functional impairment, and health-related quality of life (HRQOL) from participants enrolled in an institutional review board-approved observational study at the US NIH's Neuro-Oncology Branch were collected between September 2016 and December 2019. Descriptive statistics, tests of association, and comparison of group mean values were used to describe and evaluate PROs. RESULTS: Of the 277 participants diagnosed with a PCNST, 57% were male and 43% were female. Participants reported their race as White, non-Hispanic (78%); White, Hispanic/Latino (9%); Asian (7%); Black (4%); Native Hawaiian/Pacific Islander (1%); and other (2%) with 8% missing. The median age of the overall cohort was 45 years (range 18-74). Hispanic participants in the overall sample were 2.3 times more likely, and in the brain tumor group 3.2 times more likely, to report unemployment (p = 0.043, odds ratio [OR] 2.3, 95% CI 1.0-5.4 and p = 0.008, OR 3.2, 95% CI 1.3-7.9, respectively). 77 (28%) individuals unemployed due to tumor reported more functional impairment with walking, washing, dressing, and performing usual activities and reduced HRQOL (p < 0.001). More unemployed participants in the total sample reported moderate-to-severe depressive symptoms (25%) than those employed (8%) (χ2(1) = 13.9, p < 0.001, OR 3.7, 95% CI 1.8-7.8) and more moderate-to-severe anxiety symptoms (30%) than those employed (15%) (χ2(1) = 7.8, p = 0.005, OR 2.4, 95% CI 1.3-4.5). Unemployed participants with brain tumor reported on average 3 more symptoms as moderate-to-severe compared with those employed (t(83) = -4.0, 95% CI [Formula: see text] difference -5 to -2, p < 0.001, Hedge g = 0.70). DISCUSSION: Being unemployed due to a PCNST strongly correlated with high symptom burden, functional impairment, psychological distress, and reduced HRQOL, which may be impediments to returning to work that warrant intervention. Lack of employer-based health insurance and reduced earnings are financial sequelae of unemployment superimposed on the physical, social, and cognitive effects of living with a PCNST. Innovations to screen for and address financial toxicity and its contributing factors are needed.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Calidad de Vida / Neoplasias Encefálicas Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Neurology Año: 2023 Tipo del documento: Article
Texto completo
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Calidad de Vida / Neoplasias Encefálicas Tipo de estudio: Diagnostic_studies / Observational_studies / Risk_factors_studies Idioma: En Revista: Neurology Año: 2023 Tipo del documento: Article