Cost Effectively Improve Cancer Patients’ Quality of Life with Mindfulness
By John M. de Castro, Ph.D.
“People don’t ask to be diagnosed with cancer, but they’re given an opportunity to, in a real sense, experience the vividness and the exquisiteness of the moment.” – Linda Carlson
Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.
Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress, sleep disturbance, fear, and anxiety and depression. The effectiveness of mindfulness training for the psychological symptoms of cancer has been established. But whether it is cost-effective relative to other treatments has not been investigated.
The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many parents can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with parents’ busy schedules and at locations that may not be convenient. As an alternative, mindfulness trainings over the internet have been developed. These have tremendous advantages in making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. But the question arises as to the cost effectiveness of these online trainings.
In today’s Research News article “Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027540/), Compen and colleagues recruited past or present cancer patients with high anxiety levels and randomly assigned them to be on a wait-list receiving treatment as usual or Mindfulness-Based Cognitive Therapy (MBCT) either delivered face-to-face or over the internet. Face-to-face MBCT occurred in 8 weekly 2.5-hour sessions with 45 minutes of daily practice at home. The internet version had similar content but was delivered asynchronously personally with email exchanges with therapists.
Costs were calculated by calculating the costs of normal treatment as usual as well as indirect costs from absenteeism, productivity losses etc. and the costs of delivering the services. Quality of life was assessed for each patient.
They found that the costs of delivery of Mindfulness-Based Cognitive Therapy (MBCT) was equivalent between face-to-face and internet delivery. The productivity losses and total costs were significantly less with both MBCT deliveries compared to treatment as usual. Quality of life was significantly higher with both MBCT deliveries and was maintained at a 9-month follow-up.
The results suggest that delivering Mindfulness-Based Cognitive Therapy (MBCT) either face-to-face or over the internet reduces total costs of treatment and work-related losses and improved the quality of life of cancer patients. This suggests that MBCT is a cost effective way of delivering treatment to cancer patients, making their lives better.
So, cost effectively improve cancer patients’ quality of life with mindfulness.
“Cancer is a traumatic event that changes a person’s life. Utilizing mindfulness tools can provide peace and hope. Practicing mindfulness on a daily basis can assist with long term effects of happiness and positivity. – Erin Murphy-Wilczek
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch
Compen, F., Adang, E., Bisseling, E., van der Lee, M., & Speckens, A. (2020). Cost-utility of individual internet-based and face-to-face Mindfulness-Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients. Psycho-oncology, 29(2), 294–303. https://doi.org/10.1002/pon.5246
It was previously determined that group‐based face‐to‐face Mindfulness‐Based Cognitive Therapy (MBCT) and individual internet‐based MBCT (eMBCT) are equally efficacious compared with treatment as usual (TAU) in reducing psychological distress. In this study, the incremental cost‐utility of both interventions compared with TAU was assessed.
This cost‐utility study included 245 self‐referred heterogeneous cancer patients with psychological distress who were randomized to MBCT, eMBCT or TAU. Healthcare costs and (informal) work‐related productivity losses were assessed by interview. Outcomes were expressed in EuroQol‐5D‐3L utility scores and quality‐adjusted life years (QALY). An economic evaluation with a time‐horizon of 3 months was conducted from the societal perspective in the intention‐to‐treat sample. In addition, secondary explorative analyses of costs and quality of life during the 9‐month follow‐up were conducted based on linear extrapolation of TAU.
Paid work‐related productivity losses and societal costs were lower in both intervention conditions compared with TAU during the 3‐month intervention period. Moreover, quality of life (utility scores) improved in eMBCT versus TAU (Cohen’s d: .54) and MBCT versus TAU (.53). At a willingness to pay of €20000 per QALY, the mean incremental net monetary benefit was €1916 (SD=€783) in eMBCT and €2365 (SD=€796) in MBCT versus TAU. Exploration of costs demonstrated an equal pattern of eMBCT and MBCT being superior to TAU. Quality of life at 9‐month follow‐up remained improved in both interventions.
Results indicate that eMBCT and MBCT are cost‐saving treatments whilst simultaneously improving quality of life for distressed cancer patients.