Psycho-oncological intervention in haematopoietic progenitor cell transplant (HPT): effects of emotional impact / Intervención psicooncológica en trasplante de progenitores hematopoyéticos (TPH): efectos en el impacto emocional

The aim of this work has been to determine the repercussions a psycho-oncological program has on patients who need to undergo a haematopoietic stem cell transplantation (HPT). We have studied two groups, an intervention group (n=21), formed with patients that have gone through the program of psycho-oncologic preparation previous to the transplant, and a control group (n=15), without psychological intervention. The program consists of four sessions: analysis and handling of the information, coping skills, management of stress, and preparation for the isolation. The results show that patients who receive the psychological intervention. appear to obtain minor levels in anxiety and depression and has a more adaptive perception of the passage of time and a more positive mood with more activity than the control group. However, such differences are not significant in the perception of the physical symptomatology as the amount of time in isolation increases.

El objetivo de este trabajo ha sido determinar las repercusión un programa de intervención psicooncológica sobre los pacientes candidatos a un Trasplante de Progenitores Hematopoyéticos (TPH). Participan dos grupos de pacientes, el grupo intervención (n=21), formado por los pacientes que han realizado el programa de intervención previo al trasplante, y un grupo de control (n=15), que no recibe la intervención pre-TPH. El programa consta de cuatro módulos: análisis y manejo de la información, habilidades de afrontamiento, control del estrés, y preparación familiar al aislamiento. Los resultados muestran que los pacientes que reciben la intervención psicológica obtienen niveles menores en ansiedad y depresión y tiene una percepción más adaptativa del paso del tiempo y un estado de ánimo más positivo, con más actividad que el grupo de control. Sin embargo, tales diferencias no son significativas en la percepción de la sintomatología física que aumenta con el paso del tiempo en aislamiento.

[Sociodemographic and Clinical Factors Associated with Informal Care in Hematologic Malignancy Patients: a Study Based on Different Phases of the Treatment, Spain]. / Factores sociodemográficos y clínicos asociados a la recepción de cuidado informal en pacientes con neoplasia hematológica: estudio basado en las diferentes etapas del tratamiento.

BACKGROUND: There is little information on factors related to use of to informal care in cancer patients. Our objective is to study sociodemographic and clinical factors associated with use of informal care in patients with hematologic malignancy and analyze how these changes throughout different phases of the treatment. METHODS: 139 patients diagnosed with hematologic malignancy who received an haematopoietic stem cell transplantation between 2006-2011 in two Spanish hospitals completed the developed postal questionnaire. A binary logistic regression model was used to analyse the factors associated with use of informal care each of four phases of the treatment (pretransplant, first year, second and third year, and from the fouth to sixth year postransplant). Dependent variable was receive vs. not receive informal care. RESULTS: Patients diagnosed with acute leukemia had higher probability of receiving informal care during pretransplant period (OR = 6.394) and during the second and third year postransplantation (OR = 42.212). In the long-term (4-6 years), multiple myeloma patients were the ones who required more informal care (OR = 15.977). Health status was statistically significant during all phases. Being male (OR = 0.263), having partner (OR = 0.137) and being employed (OR = 0.110) were associated with lower likelihood of receiving informal care in the long-term. CONCLUSIONS: Over 75% of patients diagnosed with hematologic malignancy received informal care during pretrasplant and first year postransplant. Type of diagnosis and health status are decisive factors in the probability of receiving informal care at all phases, while the type of transplantation is not. Sociodemografic factors are relevant in the long-term.

Productivity loss due to premature mortality caused by blood cancer: a study based on patients undergoing stem cell transplantation / Pérdidas de productividad por mortalidad prematura debido a una neoplasia hematológica: estudio basado en pacientes sometidos a un trasplante de células madre

Introduction: Stem cell transplantation has been used for many years to treat haematological malignancies that could not be cured by other treatments. Despite this medical breakthrough, mortality rates remain high. Our purpose was to evaluate labour productivity losses associated with premature mortality due to blood cancer in recipients of stem cell transplantations. Methods: We collected primary data from the clinical histories of blood cancer patients who had undergone stem cell transplantation between 2006 and 2011 in two Spanish hospitals. We carried out a descriptive analysis and calculated the years of potential life lost and years of potential productive life lost. Labour productivity losses due to premature mortality were estimated using the Human Capital method. An alternative approach, the Friction Cost method, was used as part of the sensitivity analysis. Results: Our findings suggest that, in a population of 179 transplanted and deceased patients, males and people who die between the ages of 30 and 49 years generate higher labour productivity losses. The estimated loss amounts to over €31.4 million using the Human Capital method (€480,152 using the Friction Cost method), which means an average of €185,855 per death. The highest labour productivity losses are produced by leukaemia. However, lymphoma generates the highest loss per death. Conclusions: Further efforts are needed to reduce premature mortality in blood cancer patients undergoing transplantations and reduce economic losses (AU)

Introducción: Durante muchos años el trasplante de células madre se ha usado para tratar neoplasias hematológicas que no podrían haber sido curadas mediante otras terapias. A pesar de este avance médico, la ratio de mortalidad es aún elevada. Nuestro objetivo es evaluar las pérdidas de productividad laboral por mortalidad prematura debido a una neoplasia hematológica en receptores de trasplante de células madre. Métodos: Se recogieron datos primarios de las historias clínicas de pacientes con neoplasia hematológica, trasplantados durante los años 2006 y 2011 en dos hospitales españoles. Se realizó un análisis descriptivo y se calcularon los años potenciales de vida y los años potenciales de vida laboral perdidos. Las pérdidas de productividad laboral se estimaron usando el método del Capital Humano. El método de los Costes de Fricción se empleó como parte del análisis de sensibilidad. Resultados: En una población de 179 pacientes trasplantados y fallecidos, se dan mayores pérdidas de productividad laboral en varones y en personas de edades comprendidas entre los 30 y 49 años. La pérdida estimada está por encima de €31.4 millones usando el método del Capital Humano (€480,152 usando el método Costes Fricción), lo que significa una pérdida media de €185,855 por persona fallecida. Las mayores pérdidas globales son generadas por la leucemia. Sin embargo, el linfoma genera las mayores pérdidas por fallecimiento. Conclusiones: Mayores esfuerzos son necesarios para reducir la mortalidad prematura de pacientes trasplantados por neoplasia hematológica y reducir el impacto económico y social asociado a la misma (AU)

Productivity loss due to premature mortality caused by blood cancer: a study based on patients undergoing stem cell transplantation.

INTRODUCTION: Stem cell transplantation has been used for many years to treat haematological malignancies that could not be cured by other treatments. Despite this medical breakthrough, mortality rates remain high. Our purpose was to evaluate labour productivity losses associated with premature mortality due to blood cancer in recipients of stem cell transplantations. METHODS: We collected primary data from the clinical histories of blood cancer patients who had undergone stem cell transplantation between 2006 and 2011 in two Spanish hospitals. We carried out a descriptive analysis and calculated the years of potential life lost and years of potential productive life lost. Labour productivity losses due to premature mortality were estimated using the Human Capital method. An alternative approach, the Friction Cost method, was used as part of the sensitivity analysis. RESULTS: Our findings suggest that, in a population of 179 transplanted and deceased patients, males and people who die between the ages of 30 and 49 years generate higher labour productivity losses. The estimated loss amounts to over €31.4 million using the Human Capital method (€480,152 using the Friction Cost method), which means an average of €185,855 per death. The highest labour productivity losses are produced by leukaemia. However, lymphoma generates the highest loss per death. CONCLUSIONS: Further efforts are needed to reduce premature mortality in blood cancer patients undergoing transplantations and reduce economic losses.

Factores sociodemográficos y clínicos asociados a la recepción de cuidado informal en pacientes con neoplasia hematológica: Estudio basado en las diferentes etapas del tratamiento / Sociodemographic and clinical factors associated with informal care in hematologic malignancy patients: a study based on different phases of the treatment, Spain

Fundamentos: Los factores relacionados con la recepción de cuidado informal (CI) en pacientes oncológicos es una cuestión poco estudiada. El objetivo fue analizar los factores sociodemográficos y clínicos asociados a la recepción de cuidado informal en pacientes con neoplasia hematológica a lo largo de las diferentes etapas del tratamiento. Métodos: 139 pacientes diagnosticados de neoplasia hematológica que recibieron un trasplante de células madre durante el período 2006-2011 en dos centros sanitarios españoles completaron la encuesta elaborada para el estudio. Se estimó un modelo de regresión logística binaria para cada una de las cuatro etapas de tratamiento: pretrasplante, primer año, segundo y tercer año, cuarto al sexto año postrasplante. La variable dependiente fue recibir o no cuidado informal. Resultados: Pacientes diagnosticados de leucemia aguda presentaron mayor probabilidad de recibir CI durante la etapa pretrasplante (OR=6,394) y durante el segundo y tercer año postrasplante (OR=42,212). A largo plazo (4º-6º año) los pacientes con mieloma múltiple fueron los que requirieron mayor cuidado (OR=15,977). El estado de salud fue estadísticamente significativo en la mayoría de las etapas. Ser hombre (OR=0,263), tener pareja (OR=0,137) y estar empleado (OR=0,110) se asociaron a una menor probabilidad de recibir CI a largo plazo. Conclusiones: El CI está presente en más del 75% de los pacientes con neoplasia hematológica durante la etapa pretrasplante y primer año postrasplante. El diagnóstico y estado de salud son decisivos en la probabilidad de recibirlo, pero no el tipo de trasplante. Los factores sociodemográficos cobran protagonismo a largo plazo (AU)

Background: There is little information on factors related to use of to informal care in cancer patients. Our objective is to study sociodemographic and clinical factors associated with use of informal care in patients with hematologic malignancy and analyze how these changes throughout different phases of the treatment. Methods: 139 patients diagnosed with hematologic malignancy who received an haematopoietic stem cell transplantation between 2006-2011 in two Spanish hospitals completed the developed postal questionnaire. A binary logistic regression model was used to analyse the factors associated with use of informal care each of four phases of the treatment (pretransplant, first year, second and third year, and from the fouth to sixth year postransplant). Dependent variable was receive vs. not receive informal care. Results: Patients diagnosed with acute leukemia had higher probability of receiving informal care during pretransplant period (OR=6.394) and during the second and third year postransplantation (OR=42.212). In the long-term (4-6 years), multiple myeloma patients were the ones who required more informal care (OR=15.977). Health status was statistically significant during all phases. Being male (OR=0.263), having partner (OR=0.137) and being employed (OR=0.110) were associated with lower likelihood of receiving informal care in the long-term. Conclusions: Over 75% of patients diagnosed with hematologic malignancy received informal care during pretrasplant and first year postransplant. Type of diagnosis and health status are decisive factors in the probability of receiving informal care at all phases, while the type of transplantation is not. Sociodemografic factors are relevant in the long-term (AU)