The psychological symptom burden in partners of pancreatic cancer patients: a population-based cohort study

In the context of cancer, informal caregivers may provide support during treatment, manage the patient's medications, coordinate healthcare visits, and update friends and family, in addition to supporting patients with activities of daily living and instrumental activities of daily living.

“In the context of cancer, informal caregivers may provide support during treatment, manage the patient’s medications, coordinate healthcare visits, and update friends and family, in addition to supporting patients with activities of daily living (e.g. feeding, bathing, and dressing patients) and instrumental activities of daily living (e.g. managing finance, cooking, and cleaning) [5, 6].”

Informal caregivers were predominantly spouses to patients with pancreatic cancer (98.6%, 6058/6142).

“Informal caregivers were predominantly spouses to patients with pancreatic cancer (98.6%, 6058/6142) [5, 6, 28, 33, 34].”

Eight included studies were cross-sectional studies and one study was a prospective cohort design.

“Eight studies were cross-sectional studies [5, 27–33]. One study was a prospective cohort design [6].”

Five included studies were conducted in the USA, three in Australia, and one in Denmark.

“Five studies (three qualitative, two quantitative) were conducted in the USA [5, 28, 29, 31, 33], three (two qualitative, one quantitative) in Australia [27, 30, 32] and one quantitative study in Denmark [6].”

Excluding a large study which included 5574 informal caregivers, a total of 77 and 363 informal caregivers were included in the qualitative and quantitative studies respectively.

“Excluding a large study which included 5574 informal caregivers [6], a total of 77 and 363 informal caregivers were included in the qualitative and quantitative studies respectively.”

All four quantitative studies scored 0 points for the item assessing prospective calculation of study size.

“All four studies scored 0 points for the item assessing prospective calculation of study size [5, 6, 32, 33].”

Educational level, chronic morbidity and bereavement status were associated with an increased risk of first depression.

“Educational level, chronic morbidity and bereavement status were associated with an increased risk of first depression [6]”

There was a significantly higher first acute use (1 prescription only) of anxiolytics in partners of PC patients than in comparators.

“There was a significantly higher first acute use (1 prescription only) of anxiolytics in partners of PC patients than in comparators [6]”

The highest adjusted HR of first depression was seen the first year after diagnosis.

“The highest adjusted HR of first depression was seen the first year after diagnosis [6]”

Partners of pancreatic cancer patients had a threefold higher adjusted hazard ratio for depression (HR 3.2, 95% CI 2.9-3.7) in the first year after diagnosis compared to partners of non-cancer patients, based on the proxy of first prescription for antidepressants or hospital admission for clinical depression.

“Dengso et al. (2021) [6] used data-linkage methods and demonstrated a threefold higher adjusted hazard ratio for depression (HR 3.2 (95% CI: 2.9; 3.7)) in partners of pancreatic cancer patients in the first year after diagnosis when compared to partners of non-cancer patients, based on the proxy of first prescription for antidepressants or hospital admission for clinical depression.”

Predictors of psychological morbidity among informal caregivers were limited to sociodemographic and clinical characteristics including caregivers' chronic morbidity, education status, bereavement, and history of access to professional psychological help.

“Predictors of psychological morbidity among informal caregivers were limited to sociodemographic and clinical characteristics including caregivers’ chronic morbidity, education status, bereavement, and history of access to professional psychological help [6, 32].”

Partners of pancreatic cancer patients had a higher chance of first acute use of anxiolytics compared to partners of non-cancer patients.

“The same study showed that partners of pancreatic cancer patients had a higher chance of first acute use of anxiolytics when compared to partners of non-cancer patients [6].”

Predictors of increased risk of first depression among pancreatic cancer caregivers were low education level, chronic morbidity, and bereavement.

“Predictors of increased risk of first depression among pancreatic cancer caregivers were low education level, chronic morbidity, and bereavement [6].”

Four studies provided quantitative data on quality-of-life of informal caregivers of pancreatic cancer patients, and no studies provided qualitative data on quality-of-life.

“Four studies provided quantitative data on quality-of-life of informal caregivers [5, 6, 32, 33]. No studies provided qualitative data on quality-of-life of informal caregivers.”