Articlebronze2019

Piloting a Financial Counseling Intervention for Patients With Cancer Receiving Chemotherapy

Sheetal Mehta Kircher · Jessica Lee Yarber · Josh Rutsohn · Yanina Guevara · Madison Lyleroehr · Hannah Alphs Jackson +9 more

50 citations0/0 files storedJournal of Oncology Practice

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Economic and Financial Impacts of Cancer Cancer survivorship and care Health Literacy and Information Accessibility

Abstract

PURPOSE: National organizations encourage communication about costs of cancer care; however, few data are available on health system models for identifying and assisting patients with financial distress (FD). We report the feasibility and acceptability of a financial counseling (FC) intervention for patients who receive chemotherapy at a comprehensive cancer center. MATERIALS AND METHODS: Patients were randomly assigned 1:1 to FC or standard care. The FC arm received education, financial assistance screening, and an estimation tool with total billed charges and out-of-pocket (OOP) cost of one cycle of chemotherapy from a financial counselor through phone call and in-person visit. Participants completed measures of FD, health-related quality of life, and acceptability. RESULTS: Ninety-five participants enrolled (mean age, 61 years; 72% white; 50% commercially insured), with a 32% attrition rate between assessments. Rates of completion for the phone call, in-person, and entire intervention were 98%, 47%, and 30%, respectively. The OOP estimation tool was considered understandable and acceptable to the majority of participants. No significant changes in FD were found between arms. Emotional functioning was negatively associated with having high FD (95% CI, -0.13379 to -0.013; P = .0189). Being married was associated with a decrease in log-odds of having high FD (β = -1.916; 95% CI, -3.358 to -0.475; P = .0092). CONCLUSION: Implementation of an FC program that provides transparent cost data is feasible and acceptable. Incorporation of FC into clinical workflow, including phone counseling, is important to improve feasibility. Additional work is needed to develop tailored educational materials that are patient specific.

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2011Projections of the Cost of Cancer Care in the United States: 2010-2020 2013The Financial Toxicity of Cancer Treatment: A Pilot Study Assessing Out-of-Pocket Expenses and the Insured Cancer Patient's Experience 2016Measuring financial toxicity as a clinically relevant patient‐reported outcome: The validation of the COmprehensive Score for financial Toxicity (COST)2013Washington State Cancer Patients Found To Be At Greater Risk For Bankruptcy Than People Without A Cancer Diagnosis 2014The development of a financial toxicity patient‐reported outcome in cancer: The COST measure 2013Cost Sharing and Adherence to Tyrosine Kinase Inhibitors for Patients With Chronic Myeloid Leukemia 2014Impact of Financial Burden of Cancer on Survivors' Quality of Life 2016Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer

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2023Interventions for financial toxicity among cancer survivors: A scoping review

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