Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors?
Purpose This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15–39 years old) cancer survivors. Methods Using a cross-sectional survey, we...
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Veröffentlicht in: | Supportive care in cancer 2023-07, Vol.31 (7), p.434-434, Article 434 |
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creator | Wu, Victoria S. Benedict, Catherine Friedman, Danielle N. Watson, Samantha E. Anglade, Evanie Zeitler, Michelle S. Chino, Fumiko Thom, Bridgette |
description | Purpose
This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15–39 years old) cancer survivors.
Methods
Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients’ levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis. In a subset of survivors (
n
= 18), we conducted qualitative interviews and used thematic analysis to characterize responses.
Results
Two hundred forty-seven AYA survivors completed the survey at a mean of 7 years post treatment and with a median COST score of 13. 70% of AYA survivors did not recall having any cost discussion about their cancer treatment with a provider. Having any cost discussion with a provider was associated with decreased FT (
β
= 3.00;
p
= 0.02) but not associated with reduced OOP spending (
χ
2 = 3.77;
p
= 0.44). In a second adjusted model, with OOP spending included as a covariate, OOP spending was a significant predictor of FT (β = − 1.40;
p
= 0.002). Key qualitative themes included survivors’ frustration about the lack of communication related to financial issues throughout treatment and in survivorship, feeling unprepared, and reluctance to seek help.
Conclusion
AYA patients are not fully informed about the costs of cancer care and FT; the dearth of cost discussions between patients and providers may represent a missed opportunity to reduce costs. |
doi_str_mv | 10.1007/s00520-023-07822-3 |
format | Article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2832841177</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A755771921</galeid><sourcerecordid>A755771921</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-2d35ca4ada4cb6e8cc12adb7cacff12dd91ad2dc6266c02b4cfec6aff004158f3</originalsourceid><addsrcrecordid>eNp9kU9rFTEUxYNY7LP6BVxIwI2bqfk3k5mVlNqqUOimrkPm5uaRMpPUZKb4vr1pX2tVRLIInPzO4d4cQt5wdswZ0x8KY61gDROyYboXopHPyIYrKRst5fCcbNigeKNk2x6Sl6VcM8a1bsULcii1HNqe8w3ZfUrUhQJrKSHFQpOnPkQbIdiJjmt2WEWHkNEWpFOK22bBPP8GLelHgLDsaIjUujRhAYwLtdHRXVrjtorrtFCoOGZa1nwbblMuH1-RA2-ngq8f7iPy7fzs6vRLc3H5-evpyUUDSomlEU62YJV1VsHYYQ_AhXWjBgvec-HcwK0TDjrRdcDEqMAjdNZ7xhRvey-PyPt97k1O31csi5nrvjhNNmJaixG9FL3i9Wsq-u4v9DqtOdbp7qlOyo6xJ2prJzQh-rRkC3eh5kS3rdZ8ELxSx_-g6nE4B0gRfaj6HwaxN0BOpWT05iaH2ead4czc9W32fZvat7nv28hqevsw8TrO6H5ZHguugNwDpT7FLeanlf4T-xMwj7c2</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2832633600</pqid></control><display><type>article</type><title>Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors?</title><source>Springer Nature - Complete Springer Journals</source><creator>Wu, Victoria S. ; Benedict, Catherine ; Friedman, Danielle N. ; Watson, Samantha E. ; Anglade, Evanie ; Zeitler, Michelle S. ; Chino, Fumiko ; Thom, Bridgette</creator><creatorcontrib>Wu, Victoria S. ; Benedict, Catherine ; Friedman, Danielle N. ; Watson, Samantha E. ; Anglade, Evanie ; Zeitler, Michelle S. ; Chino, Fumiko ; Thom, Bridgette</creatorcontrib><description>Purpose
This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15–39 years old) cancer survivors.
Methods
Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients’ levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis. In a subset of survivors (
n
= 18), we conducted qualitative interviews and used thematic analysis to characterize responses.
Results
Two hundred forty-seven AYA survivors completed the survey at a mean of 7 years post treatment and with a median COST score of 13. 70% of AYA survivors did not recall having any cost discussion about their cancer treatment with a provider. Having any cost discussion with a provider was associated with decreased FT (
β
= 3.00;
p
= 0.02) but not associated with reduced OOP spending (
χ
2 = 3.77;
p
= 0.44). In a second adjusted model, with OOP spending included as a covariate, OOP spending was a significant predictor of FT (β = − 1.40;
p
= 0.002). Key qualitative themes included survivors’ frustration about the lack of communication related to financial issues throughout treatment and in survivorship, feeling unprepared, and reluctance to seek help.
Conclusion
AYA patients are not fully informed about the costs of cancer care and FT; the dearth of cost discussions between patients and providers may represent a missed opportunity to reduce costs.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-023-07822-3</identifier><identifier>PMID: 37395811</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescence ; Analysis ; Cancer ; Cancer survivors ; Cancer therapies ; Care and treatment ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Nursing ; Nursing Research ; Oncology ; Pain Medicine ; Patients ; Rehabilitation Medicine ; Surveys ; Survivor ; Teenagers ; Young adults ; Youth</subject><ispartof>Supportive care in cancer, 2023-07, Vol.31 (7), p.434-434, Article 434</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>COPYRIGHT 2023 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-2d35ca4ada4cb6e8cc12adb7cacff12dd91ad2dc6266c02b4cfec6aff004158f3</citedby><cites>FETCH-LOGICAL-c442t-2d35ca4ada4cb6e8cc12adb7cacff12dd91ad2dc6266c02b4cfec6aff004158f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-023-07822-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-023-07822-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37395811$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Victoria S.</creatorcontrib><creatorcontrib>Benedict, Catherine</creatorcontrib><creatorcontrib>Friedman, Danielle N.</creatorcontrib><creatorcontrib>Watson, Samantha E.</creatorcontrib><creatorcontrib>Anglade, Evanie</creatorcontrib><creatorcontrib>Zeitler, Michelle S.</creatorcontrib><creatorcontrib>Chino, Fumiko</creatorcontrib><creatorcontrib>Thom, Bridgette</creatorcontrib><title>Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors?</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Purpose
This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15–39 years old) cancer survivors.
Methods
Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients’ levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis. In a subset of survivors (
n
= 18), we conducted qualitative interviews and used thematic analysis to characterize responses.
Results
Two hundred forty-seven AYA survivors completed the survey at a mean of 7 years post treatment and with a median COST score of 13. 70% of AYA survivors did not recall having any cost discussion about their cancer treatment with a provider. Having any cost discussion with a provider was associated with decreased FT (
β
= 3.00;
p
= 0.02) but not associated with reduced OOP spending (
χ
2 = 3.77;
p
= 0.44). In a second adjusted model, with OOP spending included as a covariate, OOP spending was a significant predictor of FT (β = − 1.40;
p
= 0.002). Key qualitative themes included survivors’ frustration about the lack of communication related to financial issues throughout treatment and in survivorship, feeling unprepared, and reluctance to seek help.
Conclusion
AYA patients are not fully informed about the costs of cancer care and FT; the dearth of cost discussions between patients and providers may represent a missed opportunity to reduce costs.</description><subject>Adolescence</subject><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer survivors</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Rehabilitation Medicine</subject><subject>Surveys</subject><subject>Survivor</subject><subject>Teenagers</subject><subject>Young adults</subject><subject>Youth</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU9rFTEUxYNY7LP6BVxIwI2bqfk3k5mVlNqqUOimrkPm5uaRMpPUZKb4vr1pX2tVRLIInPzO4d4cQt5wdswZ0x8KY61gDROyYboXopHPyIYrKRst5fCcbNigeKNk2x6Sl6VcM8a1bsULcii1HNqe8w3ZfUrUhQJrKSHFQpOnPkQbIdiJjmt2WEWHkNEWpFOK22bBPP8GLelHgLDsaIjUujRhAYwLtdHRXVrjtorrtFCoOGZa1nwbblMuH1-RA2-ngq8f7iPy7fzs6vRLc3H5-evpyUUDSomlEU62YJV1VsHYYQ_AhXWjBgvec-HcwK0TDjrRdcDEqMAjdNZ7xhRvey-PyPt97k1O31csi5nrvjhNNmJaixG9FL3i9Wsq-u4v9DqtOdbp7qlOyo6xJ2prJzQh-rRkC3eh5kS3rdZ8ELxSx_-g6nE4B0gRfaj6HwaxN0BOpWT05iaH2ead4czc9W32fZvat7nv28hqevsw8TrO6H5ZHguugNwDpT7FLeanlf4T-xMwj7c2</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Wu, Victoria S.</creator><creator>Benedict, Catherine</creator><creator>Friedman, Danielle N.</creator><creator>Watson, Samantha E.</creator><creator>Anglade, Evanie</creator><creator>Zeitler, Michelle S.</creator><creator>Chino, Fumiko</creator><creator>Thom, Bridgette</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20230701</creationdate><title>Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors?</title><author>Wu, Victoria S. ; Benedict, Catherine ; Friedman, Danielle N. ; Watson, Samantha E. ; Anglade, Evanie ; Zeitler, Michelle S. ; Chino, Fumiko ; Thom, Bridgette</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-2d35ca4ada4cb6e8cc12adb7cacff12dd91ad2dc6266c02b4cfec6aff004158f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adolescence</topic><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer survivors</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Rehabilitation Medicine</topic><topic>Surveys</topic><topic>Survivor</topic><topic>Teenagers</topic><topic>Young adults</topic><topic>Youth</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Victoria S.</creatorcontrib><creatorcontrib>Benedict, Catherine</creatorcontrib><creatorcontrib>Friedman, Danielle N.</creatorcontrib><creatorcontrib>Watson, Samantha E.</creatorcontrib><creatorcontrib>Anglade, Evanie</creatorcontrib><creatorcontrib>Zeitler, Michelle S.</creatorcontrib><creatorcontrib>Chino, Fumiko</creatorcontrib><creatorcontrib>Thom, Bridgette</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Victoria S.</au><au>Benedict, Catherine</au><au>Friedman, Danielle N.</au><au>Watson, Samantha E.</au><au>Anglade, Evanie</au><au>Zeitler, Michelle S.</au><au>Chino, Fumiko</au><au>Thom, Bridgette</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors?</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>31</volume><issue>7</issue><spage>434</spage><epage>434</epage><pages>434-434</pages><artnum>434</artnum><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Purpose
This study aims to evaluate the associations between patient-provider cost discussions with patient-reported out-of-pocket (OOP) spending and long-term financial toxicity (FT) among adolescent and young adult (AYA; 15–39 years old) cancer survivors.
Methods
Using a cross-sectional survey, we assessed the themes and quality of patient discussions with providers about financial needs and general survivorship preparation, quantified patients’ levels of FT, and evaluated patient-reported OOP spending. We determined the association between cancer treatment cost discussion and FT using multivariable analysis. In a subset of survivors (
n
= 18), we conducted qualitative interviews and used thematic analysis to characterize responses.
Results
Two hundred forty-seven AYA survivors completed the survey at a mean of 7 years post treatment and with a median COST score of 13. 70% of AYA survivors did not recall having any cost discussion about their cancer treatment with a provider. Having any cost discussion with a provider was associated with decreased FT (
β
= 3.00;
p
= 0.02) but not associated with reduced OOP spending (
χ
2 = 3.77;
p
= 0.44). In a second adjusted model, with OOP spending included as a covariate, OOP spending was a significant predictor of FT (β = − 1.40;
p
= 0.002). Key qualitative themes included survivors’ frustration about the lack of communication related to financial issues throughout treatment and in survivorship, feeling unprepared, and reluctance to seek help.
Conclusion
AYA patients are not fully informed about the costs of cancer care and FT; the dearth of cost discussions between patients and providers may represent a missed opportunity to reduce costs.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37395811</pmid><doi>10.1007/s00520-023-07822-3</doi><tpages>1</tpages></addata></record> |
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source | Springer Nature - Complete Springer Journals |
subjects | Adolescence Analysis Cancer Cancer survivors Cancer therapies Care and treatment Medical research Medicine Medicine & Public Health Medicine, Experimental Nursing Nursing Research Oncology Pain Medicine Patients Rehabilitation Medicine Surveys Survivor Teenagers Young adults Youth |
title | Do discussions of financial burdens decrease long-term financial toxicity in adolescent and young adult cancer survivors? |
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