Abstract
Bereaved spouses or partners are thought to be at increased risk of morbidity and mortality. However, there are few large prospective studies and results are inconsistent. We estimated the relative mortality, prescription of psychotropic medication and use of primary medical care services in adults whose cohabitee died of cancer. To do this, we undertook a cohort study using The Health Improvement Network (THIN) UK primary care database. Participants were 1) people aged over 40, who were registered with general practices and had been exposed to the death of a cohabitee from cancer; and 2) a comparison cohort frequency matched on five year age bands and sex who were cohabiting with a living partner. The baseline was chosen as six months before the date of the cancer death for the exposed group and a random date for the unexposed group. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were estimated using random effects Poisson regression to account for clustering within general practices and adjusting for other key variables. 92,129 patients were studied for a median follow up of 4 years. Cohabitees of patients who died of cancer were less likely to die of any cause (IRR 0.71, CI 0.68–0.74) after adjustment for age, gender, number of non-psychotropic prescriptions 6 months before the cancer death/index date, use of psychotropic medication 6 months before the cancer death/index date, smoking, alcohol and area deprivation score. Exposed patients were more likely to receive a prescription for antidepressant or hypnotic medication and to attend their GP both before and after the death of the cohabitee. In conclusion, we did not confirm increased mortality in cohabitees of people dying from cancer.
Highlights
Grief is the constellation of psychological and physical reactions to the death of a spouse, relative, child or friend [1,2,3]
It was reported that mortality rates based on person-years at risk were not elevated for widows compared to matched controls remaining married, while the relative risk was significant for men in only those 55 years old and over [8]
Ethics statement The The Health Improvement Network (THIN) scheme for obtaining and providing anonymous patient data to researchers was approved by the National Health Service South-East Multicenter Research Ethics Committee (MREC) in 2002
Summary
Grief is the constellation of psychological and physical reactions to the death of a spouse, relative, child or friend [1,2,3]. A large cohort study of 7,735 men followed for a mean of 11.5 years in the United Kingdom showed no association between becoming widowed and subsequent cardiovascular or non-cardiovascular (usually cancer) death [7] This was in contrast to men divorced during follow-up who were at elevated risk of both types of mortality. It was reported that mortality rates based on person-years at risk were not elevated for widows compared to matched controls remaining married, while the relative risk was significant for men in only those 55 years old and over [8]. This study did not compare mortality in all bereaved participants versus those not bereaved
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