Effect of Group Therapy for Breast Cancer on Healthcare Utilization

J. Steven A. Simpson ph d, md, Linda E. Carlson ph d, Michael E. Trew md
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引用次数: 154

Abstract

Purpose: The purpose of this study was to determine whether participation in a group psychosocial intervention by patients with breast cancer would result in an improvement in psychological measures and in reduced billings in general medical expenses.

description of Study: Eligible women who had completed treatment for stage 0, I, or II primary breast cancer were prospectively and randomly assigned to either the intervention (n = 46) or control (n = 43) group. Both groups received the usual psychosocial care; however, the intervention group also participated in six weekly cognitive/behavioral psychosocial meetings. All were assessed on psychiatric symptoms, mood, depression, and coping strategies at four time periods: preintervention, postintervention, 1-year follow-up, and 2-year follow-up. Alberta Healthcare billing records were obtained covering the 2-year follow-up period to determine the amount billed per person over the course of the study.

Results: Women in the intervention group had less depression, less overall mood disturbance, better overall quality of life, and fewer psychiatric symptoms than those in the control group, beginning immediately postintervention and remaining so at 2 years postintervention. Billing in the intervention group was an average of $147 less than in the control group, a 23.5% reduction.

clinical Implications: This is the first study to show that a psychosocial intervention can reduce direct healthcare billings in a sample of patients with cancer. Importantly, these findings help to justify the routine availability of such programs in cancer treatment facilities worldwide.

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乳腺癌团体治疗对医疗保健利用的影响
目的:本研究的目的是确定乳腺癌患者参加群体心理干预是否会改善心理测量并减少一般医疗费用。研究描述:完成0期、I期或II期原发性乳腺癌治疗的符合条件的妇女被前瞻性地随机分配到干预组(n = 46)或对照组(n = 43)。两组患者均接受常规的心理社会护理;然而,干预组还参加了六次每周的认知/行为社会心理会议。在干预前、干预后、1年随访和2年随访四个时间段评估所有患者的精神症状、情绪、抑郁和应对策略。在2年的随访期间,获得了艾伯塔省医疗保健账单记录,以确定在研究过程中每人的账单金额。结果:与对照组相比,干预组的女性抑郁程度更低,整体情绪障碍更少,整体生活质量更好,精神症状更少,干预后立即开始,干预后2年仍然如此。干预组的账单比对照组平均少147美元,减少了23.5%。临床意义:这是第一个研究表明,心理社会干预可以减少癌症患者样本的直接医疗保健费用。重要的是,这些发现有助于证明在世界范围内的癌症治疗机构中这些项目的常规可用性。
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