Healthcare utilization and productivity loss in glioma patients and family caregivers: the impact of treatable psychological symptoms

Florien W. Boele*, David Meads, Femke Jansen, Irma M. Verdonck-de Leeuw, Jan J. Heimans, Jaap C. Reijneveld, Susan C. Short, Martin Klein

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Gliomas are associated with significant healthcare burden, yet reports of costs are scarce. While many costs are unavoidable there may be treatable symptoms contributing to higher costs. We describe healthcare and societal costs in glioma patients at high risk for depression and their family caregivers, and explore relationships between costs and treatable symptoms. Methods: Data from a multicenter randomized trial on effects of internet-based therapy for depressive symptoms were used (NTR3223). Costs of self-reported healthcare utilization, medication use, and productivity loss were calculated for patients and caregivers separately. We used generalized linear regression models to predict costs with depressive symptoms, fatigue, cognitive complaints, tumor grade (low-/high-grade), disease status (stable or active/progression), and intervention (use/non-use) as predictors. Results: Multiple assessments from baseline through 12 months from 91 glioma patients and 46 caregivers were used. Mean overall costs per year were M = €20,587.53 (sd = €30,910.53) for patients and M = €5,581.49 (sd = €13,102.82) for caregivers. In patients, higher healthcare utilization costs were associated with more depressive symptoms; higher medication costs were associated with active/progressive disease. In caregivers, higher overall costs were linked with increased caregiver fatigue, cognitive complaints, and lower patient tumor grade. Higher healthcare utilization costs were related to more cognitive complaints and lower tumor grade. More productivity loss costs were associated with increased fatigue (all P < 0.05). Conclusions: There are substantial healthcare and societal costs for glioma patients and caregivers. Associations between costs and treatable psychological symptoms indicate that possibly, adequate support could decrease costs. Trial registration: Netherlands Trial Register NTR3223.

Original languageEnglish
Pages (from-to)485-494
Number of pages10
JournalJournal of Neuro-Oncology
Issue number2
Early online date14 Mar 2020
Publication statusPublished - Apr 2020


We thank the Dutch Society for Neuro-Oncology and neurologists, neurosurgeons, oncologists, pathologists and nurses from all participating centers for their help in recruiting participants for this study. This work was supported by a grant from the Dutch Cancer Society, Alpe d’HuZes (VU 2010-4808). The first author was supported by a Yorkshire Cancer Research University Academic Fellowship (L389FB).

FundersFunder number
Alpe d’HuZesVU 2010-4808
Dutch Cancer Society
Dutch Society for Neuro-Oncology and neurologists
Yorkshire Cancer Research UniversityL389FB


    • Costs
    • Depression
    • Family caregiver
    • Glioma
    • Healthcare utilization
    • Work productivity


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