Communication of costs and financial burdens between cancer patients and healthcare providers: a qualitative systematic review and meta-synthesis

Kuang, Yi; Zhang, Tingting; Ma, Yan; Zhu, Zheng; So, Winnie K.W.; Xing, Weijie

doi:10.1007/s00520-023-07647-0

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…Our study additionally observed that a higher level of COVID-19-related socioeconomic distress (as measured by CSS-SE scores) was experienced by patients with lower income and elevated depression symptom severity (PHQ-8 scores). These associations are consistent with the negative impact of FT has on patients in the form of employment disruption, asset erosion, indebtedness, and psychological distress [36][37][38]. Of note, the multivariable analysis results suggested that non-White patients were more likely to experience socioeconomic stress during the COVID-19 pandemic.…”

Section: Discussionsupporting

confidence: 76%

Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States

Wu,

Liu,

Maculaitis

et al. 2023

Cancers

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This study reported the prevalence of financial distress (financial toxicity (FT)) and COVID-19-related economic stress in patients with breast cancer (BC). Patients with BC were recruited from the Ciitizen platform, Breastcancer.org, and patient advocacy groups between 30 March and 6 July 2021. FT was assessed with the COmprehensive Score for financial Toxicity (COST) instrument. COVID-19-related economic stress was assessed with the COVID-19 Stress Scale. Among the 669 patients, the mean age was 51.6 years; 9.4% reported a COVID-19 diagnosis. The prevalence rates of mild and moderate/severe FT were 36.8% and 22.4%, respectively. FT was more prevalent in patients with metastatic versus early BC (p < 0.001). The factors associated with FT included income ≤ USD 49,999 (adjusted odds ratio (adj OR) 6.271, p < 0.0001) and USD 50,000–USD 149,999 (adj OR 2.722, p < 0.0001); aged <50 years (adj OR 3.061, p = 0.0012) and 50–64 years (adj OR 3.444, p = 0.0002); living alone (adj OR 1.603, p = 0.0476); and greater depression severity (adj OR 1.155, p < 0.0001). Black patients (adj OR 2.165, p = 0.0133), patients with income ≤ USD 49,999 (adj OR 1.921, p = 0.0432), or greater depression severity (adj OR 1.090, p < 0.0001) were more likely to experience COVID-19-related economic stress. FT was common in patients with BC, particularly metastatic disease, during COVID-19. Multiple factors, especially lower income and greater depression severity were associated with financial difficulties during COVID-19.

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Section: Discussionsupporting

confidence: 76%

Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States

Wu,

Liu,

Maculaitis

et al. 2023

Cancers

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“…Patient–healthcare provider discussions about treatment costs are crucial for shared clinical decision-making in cancer care. 37 Such discussions inform patients about available treatment options, 37 , 45 better preparing them emotionally and financially for substantial expenses, and helping them avoid low-value OOP costs. 46 The American Society of Clinical Oncology emphasizes that patient–clinician communication about cancer costs is crucial for high-quality care.…”

Section: Discussionmentioning

confidence: 99%

Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study

Xu,

So,

Choi

et al. 2024

Asia-Pacific Journal of Oncology Nursing

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“…In addition, based on reports that health insurance literacy is associated with financial hardship [29], it may be important to improve patient literacy as a solution to financial toxicity. It has been suggested that patient-physician communication regarding treatment costs may reduce the financial burden [30], but there is limited mention of patient-physician discussion of the financial burden in guidelines [31]. Further research is necessary to investigate the practicality or relevance of these matters, and to elucidate the global impact of disease in terms of financial effort, not only for patients but also for medical institutions [32,33].…”

Section: Discussionmentioning

confidence: 99%

Financial Toxicity in Japanese Patients with Metastatic Renal Cell Carcinoma: A Cross-Sectional Study

Kimura,

Fujii,

Honda

et al. 2024

Cancers

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Information on the financial toxicity experienced by Japanese patients with metastatic renal cell carcinoma (mRCC) is lacking, even though Japan has its own unique public health insurance system. Thus, a web-based survey was conducted to evaluate the financial toxicity experienced by Japanese mRCC patients using the COmprehensive Score for financial Toxicity (COST) tool. This study enrolled Japanese patients who underwent, or were undergoing, systemic therapy for mRCC. The outcomes evaluated were the distribution of COST scores, the correlation between COST and quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-General (FACT-G) scale, and demographic factors associated with financial toxicity. The median (range) COST score was 19.0 (3.0–36.0). The Pearson correlation coefficient for COST and FACT-G total scores was 0.40. Univariate analysis revealed that not having private health insurance and lower household income per year were significantly associated with lower COST scores. Multivariate analyses showed that age < 65 years and not having private health insurance were significantly associated with lower COST scores. This study revealed that Japanese mRCC patients experience adverse financial impacts even under the universal health insurance coverage system available in Japan, and financial toxicity negatively affects their QOL.

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Communication of costs and financial burdens between cancer patients and healthcare providers: a qualitative systematic review and meta-synthesis

Cited by 6 publications

References 41 publications

Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States

Financial Toxicity among Patients with Breast Cancer during the COVID-19 Pandemic in the United States

Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study

Financial Toxicity in Japanese Patients with Metastatic Renal Cell Carcinoma: A Cross-Sectional Study

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