Cancer patient distress and health service use is linked with carer distress: evidence from a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: All associations p < 0.001

• Effect Size: Pooled correlations ranging from 0.28 to 0.42

• Primary Outcome: Significant associations between carer and patient psychological distress

• Nnt Or Sensitivity: Moderate effect sizes suggesting clinically meaningful associations

• Confidence Interval: Not reported in abstract

Clinical Application

Highly feasible - supports existing psychosocial care frameworks and carer support programs Directly relevant to Australian cancer care pathways, supports Medicare-funded psychology services for carers, aligns with Cancer Australia's optimal care pathways emphasising family-centred care Family carers and cancer patients across various cancer types and disease stages

Abstract

BACKGROUND: Family carers (caregivers) of cancer patients often have poor mental health, which may adversely affect patient wellbeing and health service use. We examined the evidence for this using a systematic review and meta-analyses. METHODS: We systematically searched online databases for studies reporting associations between carer psychological health and either: (a) psychological health of patients with cancer they cared for; or (b) health service use in carers or patients. Studies' risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. We undertook meta-analyses to estimate pooled correlations for the most commonly reported associations between carer and patient psychological health. For associations between carer psychological health and carer and/or patient health service use, we conducted a narrative synthesis. RESULTS: Our search identified 11,911 records, 169 of which were eligible. The majority of studies were of high-to-moderate quality. Carers who were distressed, depressed, anxious, or had poor scores in the mental component of quality of life were significantly more likely to be caring for patients with these same outcomes (pooled effect sizes ranged from 0.28 to 0.42; all p < 0.001). Subgroup analyses by gender, disease stage, and study quality revealed no substantial differences. Carers with poor psychological health used general practice, mental healthcare, and hospital services more frequently than those who were psychologically healthy, and the patients they cared for used more medications and had more frequent emergency presentations. CONCLUSION: The inclusion of carers alongside patients in early psychosocial care may improve family outcomes and reduce health service use.

References

1. 1.Huynh, T. N. T., DiSipio, T., Collins, L. G., Jones, L., Neale, R. E., & Beesley, V. L. (2026). Cancer patient distress and health service use is linked with carer distress: evidence from a systematic review and meta-analysis. Supportive Care in Cancer. https://doi.org/10.1007/s13187-019-01674-4