Assessing the financial toxicity in Tunisian cancer patients using the Comprehensive Score for Financial Toxicity (COST)

Mejri, Nesrine; Berrazega, Y.; Boujnah, Ryma; Rachdi, Haifa; Benna, Houda El; Labidi, Soumaya; Boussen, Hamouda

doi:10.1007/s00520-020-05944-6

Cited by 16 publications

(12 citation statements)

References 20 publications

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“…Patients having no out-of-pocket costs can be evaluated using the PROFFIT instrument. The COST scores of the studies in the United States, Tunisia, China, Australia, and Korea showed results similar to those of our study 11 23 24 27 30. Based on the results and our results with many samples, financial toxicity exists in countries where patients have even small out-of-pocket medical costs, and the COST tool can quantify the financial toxicity.…”

Section: Discussionsupporting

confidence: 85%

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Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer

Kajimoto

Shibutani

Nagao

et al. 2022

Int J Gynecol Cancer

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ObjectiveFinancial toxicity is a financial burden of cancer care itself, which leads to worse quality of life and higher mortality and is considered an adverse effect. The COmprehensive Score for financial Toxicity (COST) tool is a patient-reported outcome measurement used to evaluate financial toxicity. We aimed to validate the internal consistency and reproducibility of the COST tool in patients with gynecologic cancer.MethodsIn this multicenter study covering the period April 2019 to July 2021, using the COST tool in Japan, patients diagnosed with ovarian, cervical, or endometrial cancer receiving systemic anti-cancer drug therapy for more than 2 months were eligible. Patients with no out-of-pocket costs for direct medical costs were excluded. The patients answered the initial test and a retest, which was completed from 2 to 14 days after the initial test. Internal consistency and reproducibility were assessed using Cronbach’s alpha and intraclass correlation coefficient (ICC), respectively. Cronbach’s alpha ≥0.8 indicates good internal consistency, and ICC ≥0.8 is highly reliable.ResultsA total of 112 patients (ovarian: 50, cervical: 26, endometrial: 36) responded to the initial test, and 89 patients answered the retest from 2 to 14 days after the initial test. The median patient age was 58 (range, 28–78) years. The median COST score was 19. Cronbach’s alpha showed good internal consistency at 0.83 (95% CI 0.78 to 0.87). The ICC at 0.850 (95% CI 0.777 to 0.900) showed high reliability.ConclusionsThe COST tool has good internal consistency and reliable reproducibility in patients with gynecologic cancer in Japan. The COST tool quantifies financial toxicity in the insurance system, where patients have limited out-of-pocket direct medical costs. The results support the use of the COST tool in patients with gynecologic cancer.

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Section: Discussionsupporting

confidence: 85%

“…The reason for this is unclear, but it may be sampling bias due to the small sample size of the subgroup analysis. In a study conducted in Tunisia, the COST score showed a normal distribution 27. Ovarian, cervical, and endometrial cancers had similar modes and distributions on the histogram, as in another study in Japan 5.…”

Section: Discussionsupporting

confidence: 56%

Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer

Kajimoto

Shibutani

Nagao

et al. 2022

Int J Gynecol Cancer

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“…Regarding disease characteristics, advanced cancer and receiving targeted therapy are both risk factors for FT. Advanced nasopharyngeal cancer requires more systemic treatments, such as innovative drugs and diagnostic methods, thereby directly increasing the medical costs (33). Nevertheless, several studies (11,34,35) have suggested that indirect medical costs for cancer treatment, such as transportation, accommodation, and time expenditure can also contribute to the Odd ratio(95%CI)…”

Section: Discussionmentioning

confidence: 99%

Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: A cross-sectional study in western China

Jiang

Mou²,

Lyu³

et al. 2022

Front. Oncol.

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Objective Using the Comprehensive Score for Financial Toxicity (COST) tool to measure financial toxicity (FT) among nasopharyngeal cancer (NPC) patients in western China and investigate the association between FT and psychological distress.MethodsWe conducted a cross-sectional study of survivors with NPC in a tertiary oncology hospital in China. FT was assessed using the COST (Chinese version), a validated instrument widely used both at home and abroad. The NCCN Distress Thermometer (DT) was used to measure psychological distress. A multivariate logistic regression model was built to determine factors associated with FT, and the Pearson correlation was used to assess the correlation between COST and DT scores.ResultsOf 210 patients included in this study, the mean FT score was 16.3 (median: 22.5, SD: 9.7), and the prevalence of FT was 66.2% (mild FT: 37.1%, moderate FT: 50.5%, severe FT: 2.4%). Suggested by the logistic regression model, 5 variables were associated with increased FT: unemployed, no commercial insurance, receiving lower annual income, advanced cancer, and receiving targeted therapy. The Pearson correlation showed a significantly moderate correlation between financial toxicity and psychological distress (r= -0.587, P < 0.001).ConclusionPatients with nasopharyngeal carcinoma (NPC) in western China demonstrated higher self-reported financial toxicity (FT) associated with factors including unemployed, no commercial insurance, receiving lower annual income, advanced cancer, and receiving targeted therapy. These predictors will help clinicians identify potential patients with FT in advance and conduct effective psychological interventions.

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“…A structured effort in continuous medical education, at the national, regional, and Arab levels may improve oncologists in terms of Good Clinical Practice (GCP). At the social level, an effort is mandatory to sustain patients and their families, due to the induced "financial toxicity" [47].…”

Section: The Future Of Cancer Care In Tunisiamentioning

confidence: 99%

General Oncology Care in Tunisia

Mejri

Rachdi

Kochbati

et al. 2022

Cancer in the Arab World

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Tunisia is the smallest country in the Maghreb region, in terms of square and the third in terms of population. It has homogeneous health coverage and an efficient primary care structure. Medical oncology, surgical oncology, radiotherapy, pediatric oncology, and Bone Marrow Transplantation are provided to all geographic regions and practiced according to the national (scientific societies of medical oncology, radiotherapy, and surgical oncology) and international guidelines. Clinical trials and translational research are encouraged despite limited resources. The quality of care provided in public and private oncology structures involves not only nationals, but also Libyan and African citizens. Continuous medical education is sustained by authorities and scientific societies, as well as scientific publications and translational research.

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Assessing the financial toxicity in Tunisian cancer patients using the Comprehensive Score for Financial Toxicity (COST)

Cited by 16 publications

References 20 publications

Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer

Validity of the COmprehensive Score for financial Toxicity (COST) in patients with gynecologic cancer

Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: A cross-sectional study in western China

General Oncology Care in Tunisia

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