A systematic review on the impact of financial insecurity on the physical and psychological well-being for people living with terminal illness

Background: People living with terminal illness are at higher risk of experiencing financial insecurity. The variance in definitions of financial insecurity, in addition to its impact on the well-being of this population has not yet been systematically analysed. 

Aim: To understand the definition, prevalence and impact of financial insecurity on the physical and psychological well-being of people living with terminal illness. 

Design: A systematic review with a narrative synthesis (prospectively registered; CRD42023404516). 

Data sources: Medline, Embase, CINAHL, AMED, PsycINFO, ProQuest Central and Cochrane Central Register of Controlled Trials, from inception to May 2023. Included studies had to measure or describe the impact of financial insecurity on an aspect of participants’ physical or mental well-being. Study quality was assessed using the Hawker tool. 

Results: A total of 26 studies were included in the review. Financial insecurity was defined using many different definitions and terminology. Out of 4824 participants, 1126 (23%) reported experiencing high levels of financial insecurity. Nine studies reported 21 unique analyses across three domains of physical well-being. Out of those 21 analyses, 10 (48%) reported a negative result (an increase in financial insecurity was reported with a decrease in physical well-being). Twenty-one studies reported 51 unique analyses across nine domains of psychological well-being. Out of these analyses, 35 (69%) reported a negative result (an increase in financial insecurity was reported with a decrease in psychological well-being). 

Conclusions: People living with terminal illness require support with their financial situation to ensure their well-being is not negatively impacted by financial insecurity.