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Observational Study
. 2021 Apr;186(2):577-583.
doi: 10.1007/s10549-021-06112-y. Epub 2021 Feb 18.

(Ex-)breast cancer patients with (pre-existing) symptoms of anxiety and/or depression experience higher barriers to contact health care providers during the COVID-19 pandemic

Dieuwke R Mink van der Molen  1 , Claudia A Bargon  1   2 , Marilot C T Batenburg  1 , Roxanne Gal  1 , Danny A Young-Afat  3 , Lilianne E van Stam  1 , Iris E van Dam  4 , Femke van der Leij  4 , Inge O Baas  5 , Miranda F Ernst  6 , Wiesje Maarse  7 , Nieke Vermulst  8 , Ernst J P Schoenmaeckers  9 , Thijs van Dalen  10 , Rhodé M Bijlsma  5 , Annemiek Doeksen  2 , Helena M Verkooijen  11   12 ; UMBRELLA study group
Affiliations
Observational Study

(Ex-)breast cancer patients with (pre-existing) symptoms of anxiety and/or depression experience higher barriers to contact health care providers during the COVID-19 pandemic

Dieuwke R Mink van der Molen et al. Breast Cancer Res Treat. 2021 Apr.

Abstract

Purpose: To identify factors associated with (perceived) access to health care among (ex-)breast cancer patients during the COVID-19 pandemic.

Methods: Cross-sectional study within a large prospective, multicenter cohort of (ex-)breast cancer patients, i.e., UMBRELLA. All participants enrolled in the UMBRELLA cohort between October 2013 and April 2020 were sent a COVID-19-specific survey, including the Hospital Anxiety and Depression Scale (HADS) questionnaire.

Results: In total, 1051 (66.0%) participants completed the survey. During COVID-19, 284 (27.0%) participants reported clinically relevant increased levels of anxiety and/or depression, i.e., total HADS score ≥ 12. Participants with anxiety and/or depression reported statistically significant higher barriers to contact their general practitioner (47.5% vs. 25.0%, resp.) and breast cancer physicians (26.8% vs. 11.2%, resp.) compared to participants without these symptoms. In addition, a higher proportion of participants with anxiety and/or depression reported that their current treatment or (after)care was affected by COVID-19 compared to those without these symptoms (32.7% vs. 20.5%, resp.). Factors independently associated with symptoms of anxiety and/or depression during COVID-19 were pre-existent anxiety (OR 6.1, 95% CI 4.1-9.2) or depression (OR 6.0, 95% CI 3.5-10.2).

Conclusion: During the COVID-19 pandemic, (ex-)breast cancer patients with symptoms of anxiety and/or depression experience higher barriers to contact health care providers. Also, they more often report that their health care was affected by COVID-19. Risk factors for anxiety and/or depression during COVID-19 are pre-existent symptoms of anxiety or depression. Extra attention-including mental health support-is needed for this group.

Keywords: Anxiety; Breast cancer; COVID-19; Depression; Patient-reported outcomes; UMBRELLA.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

References

    1. Dinmohamed AG, Visser O, Verhoeven RHA, et al. Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. Lancet Oncol. 2020 doi: 10.1016/S1470-2045(20)30265-5. - DOI - PMC - PubMed
    1. Batenburg R, Vis E, Keuper J, Bosmans MLC (2020) Drukte en uitgestelde zorgvraag door de COVID-19-pandemie: regionale verschillen. Gevolgen corona in de huisartsenpraktijk. Nivel, Utrecht. https://www.nivel.nl/sites/default/files/bestanden/1003770_2.pdf. Accessed 29 June 2020
    1. Wang Y, Duan Z, Ma Z, et al. Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic. Transl Psychiatry. 2020;10:263. doi: 10.1038/s41398-020-00950-y. - DOI - PMC - PubMed
    1. Young-Afat DA, van Gils CH, van den Bongard HJGD, et al. The Utrecht cohort for Multiple BREast cancer intervention studies and Long-term evaLuAtion (UMBRELLA): objectives, design, and baseline results. Breast Cancer Res Treat. 2017;164:445–450. doi: 10.1007/s10549-017-4242-4. - DOI - PMC - PubMed
    1. Gal R, Monninkhof EM, van Gils CH, et al. The Trials within cohorts design faced methodological advantages and disadvantages in the exercise oncology setting. J Clin Epidemiol. 2019 doi: 10.1016/j.jclinepi.2019.05.017. - DOI - PubMed

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