18 Psychosocial Wellbeing and Health Care Resource Utilization Among Patients With Breast Cancer During COVID-19

Background

Global efforts are underway to assess the impact of COVID-19 on patients with cancer; data on outcomes from the perspective of patients with breast cancer (BC) are limited. This study described psychosocial well-being and health care resource utilization (HCRU) among patients with BC during the pandemic.

Materials and Methods

From March 30 to July 6, 2021, 669 patients with BC 18 years or older from Ciitizen, a patient-mediated health records and real-world evidence platform, and patient advocacy groups participated in an online survey. Sociodemographic and health characteristics, HCRU in the past 3 months, and psychosocial well-being were assessed via descriptive analysis.

Results

Of 669 patients, median age was 52 years (range, 28-82), 83.9% were White, and 51.4% had metastatic BC. More than half (58.7%) were currently being treated with hormone therapy. A total of 62 (9.3%; 95% CI, 7.3%-11.7%) reported ever being diagnosed with COVID-19. Patients had a median of
9 (interquartile range [IQR], 5-15) health care provider (HCP) visits in the past 3 months, of which a median of 6 (IQR, 3-12) were BC related. Of the 12.9% with ≥1 emergency department visits in the past 3 months, a median of 1 (IQR, 0-1) was BC related; of the 9.1% with ≥1 hospitalizations in the past 3 months, a median of 2 (IQR, 1-3) were BC related. The prevalence of depressive symptoms in the past 2 weeks was 31.1% (95% CI, 27.7%-34.7%). The lowest Functional Assessment of Cancer Therapy subscale scores were observed for emotional and functional well-being; of those Psychological Impact of Cancer subscales that measure negative coping responses, scores were highest on emotional distress (Table).

Conclusions

The prevalence of COVID-19 diagnosis among patients with BC was high. HCRU in the past 3 months was primarily driven by HCP visits, both all-cause and due to BC. Results also suggest impairments to psychosocial well-being, particularly aspects of mental health and emotional functioning. These findings underscore the unique vulnerability, burden, and unmet needs among patients with BC during the COVID-19 pandemic.

Author Affiliations:

Martine C. Maculaitis,¹ Xianchen Liu,² Alexandra Berk,³ Angelina Massa,³ Marisa C. Weiss,⁴ Samantha K. Kurosky,² Benjamin Li,² Lynn McRoy²

¹Cerner Enviza, Malvern, PA

²Pfizer Inc, New York, NY

³Invitae, San Francisco, CA

⁴Breastcancer.org, Ardmore, PA