Communicating the Financial Burden of Treatment With Patients

Nipp, Ryan David; Sonet, Ellen; Guy, Gery P.

doi:10.1200/edbk_201051

Cited by 18 publications

(12 citation statements)

References 58 publications

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“…The financial burden of cancer treatment also extends to other hidden or indirect costs, for example, because of time lost from employment because of treatment or early retirement. Our findings align with other research in this area, clearly stressing the problematic nature of OOPCs and the "financial toxicity" of cancer treatment [33,[49][50][51][52]. Financial burden is particularly problematic considering that elderly patients are typically low-income earners (either retired or working part-time) and are more likely to have co-morbidities compared to their younger counterparts.…”

Section: Discussionsupporting

confidence: 82%

Burden of Treatment among Elderly Patients with Cancer: A Scoping Review

2021

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Background: The objective of this scoping review is to understand how treatment burden is experienced in elderly patients with cancer and what the most prevalent dimensions of treatment burden are among this population. According to one conceptual model, there are six dimensions of treatment burden, including financial, medication, administrative, time/travel, lifestyle, and healthcare. Methods: A scoping review methodology framework was used to collected data from EMBASE CINAHL (Cumulative Index to Nursing and Allied Health Literature), Medline/PubMed, Scopus, Web of Science, Embase, and Cochrane from 2000 to March 2020. Studies which focused on treatment burden among elderly patients with cancer (+65 years) were selected. Data were extracted using a standardized proforma. Results: The results identified 3319 total papers. Of these, 24 met the inclusion criteria and were included in the scoping review. A significant proportion of these studies was conducted in the United States (n = 10) using self-reported, cross-sectional data. Financial burden was the most prevalent dimension of treatment burden, with 11 studies focusing on the direct and indirect costs associated with cancer treatment. Other but less obvious aspects of treatment burden elderly patients experienced included the length of time taken to access and administer treatment and medication-related burdens. Conclusion: Emerging findings suggest that the financial aspects of cancer treatment are a significant burden for most elderly cancer patients. Personalized healthcare interventions targeting ways to reduce and screen for treatment burden, particularly those related to cost, are urgently needed.

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Section: Discussionsupporting

confidence: 82%

Burden of Treatment among Elderly Patients with Cancer: A Scoping Review

2021

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“…Furthermore, Nipp and colleagues (2018) recommend specific strategies to assess and intervene in patients’ experience of financial burden. 42 They suggest that resource information can be made available in the waiting room to connect patients to financial and psychosocial support services; providers can integrate financial burden screening tools within their practice and link patients and families to a financial counselor when a problem is identified; assessment of financial hardship can be integrated into a general assessment of decision-making needs about the course of treatment and end-of-life care, which could include advance care planning and advance directive documentation 43 ; and finally, integrating a routine assessment of financial hardship is important to advocate for improved care to meet the needs of vulnerable Latino patients and their families. 44…”

Section: Discussionmentioning

confidence: 99%

Financial Hardship and Health Related Quality of Life Among Older Latinos With Chronic Diseases

Nedjat-Haiem

Cadet

Parada

et al. 2020

Am J Hosp Palliat Care

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Background: Financial hardship influences health-related quality of life (HRQoL) of older adults. However, little is known about the relationship between financial hardship and HRQoL among vulnerable populations. Objective: We examined the associations between financial hardship and HRQoL among older Latinos living with chronic disease, including cancer. Methods: This cross-sectional study included 68 Latinos (age range 50-87) with one or more chronic health conditions who participated in a pilot randomized clinical trial. Participants responded to 11 financial hardship questions. We used factor analysis to explore constructs of financial hardship. HRQoL was assessed using the 27-item Functional Assessment of Cancer Therapy-General (FACT-G). Multiple linear regression examined the associations between financial hardship and HRQoL subscales (physical, social/family, emotional, functional well-being). Results: The factor analysis revealed 3 constructs of financial hardship: medical cost concerns, financial hardship treatment adherence, and financial worry. A 1-point increase in the factor score for financial hardship treatment adherence was associated with a 2.1-point (SE = 0.771) decrease in physical well-being and with a 1.71-point (SE = 0.761) decrease in functional well-being. A 1-point increase in the financial stress factor score was associated with a 2.0-point (SE = 0.833) decrease in social/family well-being, and with a 2.1-point (SE = 0.822) decrease in functional well-being. Conclusion: In this study of older Latinos with chronic diseases, financial hardship was associated with worse HRQoL across several domains. Healthcare providers should refer older Latinos living with chronic disease to appropriate support providers, such as care coordinators, social workers, or patient navigators, who can assist them with obtaining financial assistance and other resources.

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“…Thus navigators could help to reduce stress by identifying pathways for patients based on their specific financial and health needs. Insurance navigation could be integrated into the roles of patient navigators or social workers at the hospital . Navigation services might be covered by the hospital system itself or in collaboration with insurers.…”

Section: Discussionmentioning

confidence: 99%

“…Insurance navigation could be integrated into the roles of patient navigators or social workers at the hospital. 44 Navigation services might be covered by the hospital system itself or in collaboration with insurers.…”

Section: Insurancementioning

confidence: 99%

“…Our findings align with other recent findings of patients' desire for physicians to have some of these conversations, whereas clinicians have expressed concerns about appropriateness, ability to supply accurate information, and time barriers. 44 Although physicians could provide a list of references for patients to seek financial counseling in their offices, as patients suggested, this approach may increase their time costs; therefore, automatic referral by the physician or by another member of the health care team to a program that is integrated within the health system may be more efficient.…”

Section: Financial Assistancementioning

confidence: 99%

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Patient recommendations for reducing long‐lasting economic burden after breast cancer

Dean

Moss

Rollinson

et al. 2019

Cancer

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Background In the United States, patients who have breast cancer experience significant economic burden compared with those who have other types of cancers. Cancer‐related economic burden is exacerbated by adverse treatment effects. Strategies to resolve the economic burden caused by breast cancer and its adverse treatment effects have stemmed from the perspectives of health care providers, oncology navigators, and other subject‐matter experts. For the current study, patient‐driven recommendations were elicited to reduce economic burden after 1) breast cancer and 2) breast cancer‐related lymphedema, which is a common, persistent adverse effect of breast cancer. Methods Qualitative interviews were conducted with 40 long‐term breast cancer survivors who were residents of Pennsylvania or New Jersey in 2015 and were enrolled in a 6‐month observational study. Purposive sampling ensured equal representation by age, socioeconomic position, and lymphedema diagnosis. Semistructured interviews addressed economic challenges, supports used, and patient recommendations for reducing financial challenges. Interviews were coded, and representative quotes from the patient recommendations were analyzed and reported to illustrate key findings. Results Of 40 interviewees (mean age, 64 years; mean time since diagnosis, 12 years), 27 offered recommendations to reduce the economic burden caused by cancer and its adverse treatment effects. Nine recommendations emerged across 4 major themes: expanding affordable insurance and insurance‐covered items, especially for lymphedema treatment (among the 60% who reported lymphedema); supportive domestic help; financial assistance from diagnosis through treatment; and employment‐preserving policies. Conclusions The current study yielded 9 actionable, patient‐driven recommendations—changes to insurance, supportive services, financial assistance, and protective policies—to reduce breast cancer‐related economic burden. These recommendations should be tested through policy and programmatic interventions.

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Communicating the Financial Burden of Treatment With Patients

Cited by 18 publications

References 58 publications

Burden of Treatment among Elderly Patients with Cancer: A Scoping Review

Burden of Treatment among Elderly Patients with Cancer: A Scoping Review

Financial Hardship and Health Related Quality of Life Among Older Latinos With Chronic Diseases

Patient recommendations for reducing long‐lasting economic burden after breast cancer

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