Evaluation of psychological distress and financial toxicity in dyads of cancer patients undergoing chemotherapy and their caregivers at tertiary care hospitals in Western India.

PURPOSE: This study examined psychological distress and financial toxicity among cancer patient-caregiver dyads receiving chemotherapy in Western India, focusing on emotional and financial interdependence.

METHODS

In this cross-sectional study of 357 chemotherapy patient-caregiver dyads, psychological distress (NCCN Distress Thermometer), financial toxicity (COST-FACIT), and adverse drug reactions (standard causality and severity scales) were assessed, with patient predictors analyzed by multivariable logistic regression and dyadic effects examined using the Actor-Partner Interdependence Model.

RESULTS

Clinically significant distress was reported by 55.74% of patients and 10.92% of caregivers, while nearly 70% of both groups experienced mild-to-moderate financial toxicity. Patient distress was significantly associated with adverse drug reactions (AOR = 2.208), higher patient financial toxicity (AOR = 0.895), caregiver financial toxicity (AOR = 1.056), and caregiver distress (AOR = 1.951). Caregiver distress was significantly associated with caregiver financial toxicity (AOR = 1.19), patient distress (AOR = 0.72), breadwinner status, and marital status. APIM showed strong actor effects for patients (β = 0.446) and caregivers (β = 0.366), and partner effects indicating cross-dyad influence (β = 0.157; β = 0.168).

CONCLUSIONS

Psychological distress and financial toxicity are prevalent, and addressing patient-caregiver interdependence-particularly in primary caregivers and patients with treatment toxicities-may improve outcomes.