Correlates of financial toxicity in adult cancer patients and their informal caregivers

Sadigh, Gelareh; Switchenko, Jeffrey M.; Weaver, Kathryn E.; Elchoufi, Deema; Meisel, Jane L.; Bilen, Mehmet Asım; Lawson, David H.; Cella, David; El‐Rayes, Bassel F.; Carlos, Ruth C.

doi:10.1007/s00520-021-06424-1

Cited by 39 publications

(31 citation statements)

References 37 publications

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“…As a result, the social worker or navigator may also coordinate referrals for other patient needs, including psychological distress or symptom management. Additional resources may be needed to help relieve the burdens of the patients’ informal caregivers, who experience their own financial and psychological strains 54,55 . Such collaborative work of health care team members is invaluable to accomplish financial navigation as a component of high‐quality, high‐value care delivery 53 .…”

Section: Emerging Practices For Multidisciplinary Management Of Patie...mentioning

confidence: 99%

“…Additional resources may be needed to help relieve the burdens of the patients' informal caregivers, who experience their own financial and psychological strains. 54,55 Such collaborative work of health care team members is invaluable to accomplish financial navigation as a component of high-quality, high-value care delivery. 53 Thus, while social workers or nurse navigators lead financial navigation, the synchronous support and collaboration of multidisciplinary team members, including the clinical team, are needed to optimize efforts to mitigate FT in care.…”

Section: Financial Navigationmentioning

confidence: 99%

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Navigating financial toxicity in patients with cancer: A multidisciplinary management approach

Smith

Banegas

Acquati

et al. 2022

CA A Cancer J Clinicians

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Approximately one-half of individuals with cancer face personal economic burdens associated with the disease and its treatment, a problem known as financial toxicity (FT). FT more frequently affects socioeconomically vulnerable individuals and leads to subsequent adverse economic and health outcomes. Whereas multilevel systemic factors at the policy, payer, and provider levels drive FT, there are also accompanying intervenable patient-level factors that exacerbate FT in the setting of clinical care delivery. The primary strategy to intervene on FT at the patient level is financial navigation. Financial navigation uses comprehensive assessment of patients' risk factors for FT, guidance toward support resources, and referrals to assist patient financial needs during cancer care. Social workers or nurse navigators most frequently lead financial navigation. Oncologists and clinical provider teams are multidisciplinary partners who can support optimal FT management in the context of their clinical roles. Oncologists and clinical provider teams can proactively assess patient concerns about the financial hardship and employment effects of disease and treatment. They can respond by streamlining clinical treatment and care delivery planning and incorporating FT concerns into comprehensive goals of care discussions and coordinated symptom and psychosocial care. By understanding how age and life stage, socioeconomic, and cultural factors modify FT trajectory, oncologists and multidisciplinary health care teams can be engaged and informative in patient-centered, tailored FT management. The case presentations in this report provide a practical context to summarize authors' recommendations for patient-level FT management, supported by a review of key supporting evidence and a discussion of challenges to mitigating FT in oncology care.

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Section: Emerging Practices For Multidisciplinary Management Of Patie...mentioning

confidence: 99%

Section: Financial Navigationmentioning

confidence: 99%

Navigating financial toxicity in patients with cancer: A multidisciplinary management approach

Smith

Banegas

Acquati

et al. 2022

CA A Cancer J Clinicians

View full text Add to dashboard Cite

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“…External financial resources for cancer caregivers are limited, and caregivers report high unmet financial needs 5, 8 . Increased financial burden in caregivers negatively impacts patients' health and care delivery as it is associated with poorer treatment adherence and quality of life 9 …”

Section: Introductionmentioning

confidence: 99%

“…5,8 Increased financial burden in caregivers negatively impacts patients' health and care delivery as it is associated with poorer treatment adherence and quality of life. 9 Cancer-related financial burden may be exacerbated in those providing care to adolescent and young adult (AYA) survivors (i.e., those diagnosed with cancer from the ages of 15-39 years), a population at high risk for having inadequate insurance coverage and limited financial assets. [10][11][12][13] Compared to other age groups with cancer, AYAs self-report greater financial burden.…”

Section: Introductionmentioning

confidence: 99%

Financial burden for caregivers of adolescents and young adults with cancer

et al. 2022

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Objective: Adolescent and young adult (AYA) cancer survivors are vulnerable to cancer-related financial burden, which is likely shared by their caregivers. This study aims to enhance an existing conceptual model of financial burden by conducting concept elicitation interviews with caregivers to generate knowledge that can be translated to inform instrumental and psychosocial support in cancer care. Methods: Qualitative concept elicitation interviews were conducted with 24 caregivers of AYA cancer survivors (caregivers of adolescents, n = 12; caregivers of emerging adults, n = 12) recruited from four sites. Constant comparative methods were used to identify themes, and results were interpreted and organized into domains of the conceptual model. We also explored COVID-19 related financial impacts among a subset (n = 12) of caregivers. Results: Seven themes emerged, which varied by age group and strengthened the conceptualization of the model. Themes centered on: (1) direct and indirect costs of cancer; (2) impact of socioeconomic status on financial burden; (3) caregiver desire to shield AYAs from distress due to financial burden; (4) strategies to manage cancer-related costs; (5) worries about AYAs' financial future; (6) seeking and

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“…Nonadherence has been reported as a means of coping, however maladaptively, with the high cost of cancer treatment across a broad range of populations, including adolescents and young adults, gynecological cancer patients, breast cancer patients, and caregiver-patient dyads [19][20][21][22]. Predictors of nonadherence include lower income, less education, lack of insurance or prescription drug coverage, high out-of-pocket medical costs, and enrollment in a high deductible health insurance plan without an accompanying health savings account [23].…”

Section: Discussionmentioning

confidence: 99%

Administrative Burden Associated with Cost-Related Delays in Care in U.S. Cancer Patients

Doherty

Thom

Gardner

2022

Preprint

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Purpose: U.S. cancer patients engage in a range of administrative tasks to pay for their healthcare (e.g., estimating costs, negotiating with insurers, and making sense of bills). This study investigates the relationship between payment tasks and timely access to cancer care. Methods: We administered a web-based survey to 510 cancer patients and survivors, stratified by cancer type and geographic region, to assess their financial and insurance concerns and experiences. Logistic regression was used to determine if there was an independent relationship between number of administrative payment tasks and odds of cost-related delay/nonadherence. Results: Younger patients (£ 44 years) reported more payment tasks and cost-related delays/nonadherence than older patients (³ 55 years); African American patients reported more payment tasks and cost-related delays/nonadherence than white patients. After accounting for age, race/ethnicity, education, and estimated out-of-pocket costs, patients who reported engaging in more tasks had greater odds of delaying or forgoing care due to cost (OR = 1.53, 95% CI: 1.26, 1.85). Conclusion: Payment tasks increased the odds of cost-related delays and nonadherence by over 50%, taking the form of delayed or skipped doctor appointments, tests and bloodwork, and prescription fulfillment. Younger patients and those identifying as African American were more likely to engage in payment tasks and delay or forgo care due to cost. Administrative burdens can disrupt access to care and traditionally underserved patient populations are disproportionately exposed to these hardships. Reducing the administrative complexity of healthcare through universal, human-centered design could reduce burdens and increase access.

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Correlates of financial toxicity in adult cancer patients and their informal caregivers

Cited by 39 publications

References 37 publications

Navigating financial toxicity in patients with cancer: A multidisciplinary management approach

Navigating financial toxicity in patients with cancer: A multidisciplinary management approach

Financial burden for caregivers of adolescents and young adults with cancer

Administrative Burden Associated with Cost-Related Delays in Care in U.S. Cancer Patients

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