Evaluating Caregiver Burden as a Predictive Factor for Patient Outcomes in Patients Receiving Anti-cancer Systemic Therapy at a Tertiary Institution in Cebu City

Background: Though found to be a common occurrence in individuals caring for patients with debilitating illnesses such as cancer, caregiver burden remains underprioritized, and its relationship with patient outcomes is only sparingly described. Methodology: This cross-sectional, observational study included 50 patient-caregiver pairs receiving anti-cancer systemic therapy at a tertiary hospital in Cebu City. Sociodemographic and clinical characteristics were obtained. Patient quality of life was measured using the EQ-5D-5L Questionnaire, while caregiver burden was assessed with the Zarit Burden Interview. The association between caregiver burden and patient outcomes were examined using multivariate logistic regression models and bivariate analysis.Results: Patients included in the study were predominantly females, middle-aged to elderly, and in advanced stages of disease, whereas caregivers were mostly female, and younger in relation. The usual patient-caregiver relationships were spousal and parental. Educational attainment, employment status and income varied among caregivers, and were significantly associated with caregiver burden, as were patient age, a lung primary, and limitations in patient mobility, self-care and ability to perform usual activities. On the other hand, higher levels of caregiver burden were linked to quality of life impairment, increased anxiety or depression, and more frequent hospital admissions for patients.Discussion: The level of care in patients requiring continuous assistance often leads to an imbalance of care demands relative to the caregiver’s personal time and space, roles and resources, the latter being particularly relevant in the third-world setting where healthcare expenditure remains largely out-of-pocket. Patients likewise suffer from the burden they unwillingly impose on caregivers, with self-perceived burden contributing significantly to patient anxiety and depression, and influencing therapeutic choices in the direction of palliative care over curative therapy. Additionally, a higher level of caregiver burden was found to compromise the quality of care, and increase reliance on health systems, often leading to more frequent hospital admissions, perpetuating a vicious cycle of demand and burden.Conclusions: Financial standing, which can be influenced by educational attainment, employment status and income, was found to be significantly associated with caregiver burden. Patient-related factors such as age, a lung primary, and assistance requirement were also associated factors. Conversely, caregiver burden was found to influence patient quality of life via the impairment of mobility, self-care and ability to perform activities of daily living, and an increase in anxiety or depression. Higher levels of caregiver burden were also found to be associated with a higher frequency of hospital admissions for the patient.