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
Hauptverfasser: Wu, Victoria S., Benedict, Catherine, Friedman, Danielle N., Watson, Samantha E., Anglade, Evanie, Zeitler, Michelle S., Chino, Fumiko, Thom, Bridgette
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container_end_page 434
container_issue 7
container_start_page 434
container_title Supportive care in cancer
container_volume 31
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
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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 &amp; 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 &amp; 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. ; 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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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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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