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Financial toxicity has become a well-established issue in cancer care, since the term was coined by S. Yousuf Zafar, MD, and Amy Abernethy, MD, Duke Cancer Institute in Durham, North Carolina, for describe an "adverse event" increasingly experienced by cancer patients
Despite the growing focus on cancer costs and the need to treat this aspect of clinical care, a new study found that subject
The results were published online July 23 in Cancer .
They come from an investigation that included 306 medical oncologists. About half of them said that someone in their practice often or always discussed the financial burden with patients.
Of the patients who responded that they were worried about finances, nearly three-quarters said that their doctors and staff offered no help.
Of those patients who wanted to discuss the impact of bad cancer on employment or finances, 55% indicated that they had not had any relevant discussion at this time. subject with their provider.
"There seems to be a growing awareness in oncology community of financial toxicity and the need for providers to support patients in this regard," said lead author Reshma Jagsi, MD, DPhil, of the Department of Radiation Oncology at the University of Michigan, Ann Arbor.
But It's a Fat She said Medscape Medical News
"A Potential Intervention Strategy useful involves communication tr said Jagsi, who is also director of the Center for Bioethics and Social Sciences in Medicine.
"These kinds of interventions need to be developed and evaluated in future research if we want to advance the needle on this topic." A gap remains
There is little evidence on the issue of whether increasing attention to financial issues has led physicians to more systematically adopt practices to mitigate financial toxicity, note the authors.] 19659003] Little is known about the level of physician involvement in Regarding patients 'financial toxicity or patients' perception of the satisfaction of their needs, they write.It's what motivated them to conduct the investigation. [19659012] The investigation involved 2502 patients with early bad cancer, 370 surgeons, 306 medical oncologists and 169 radiation oncologists
Of medical oncologists, 50.9% said they discuss or always financial problems with patients, as did 15.6% of surgeons and 43.2% of radiation oncologists.
Forty percent of medical oncologists also believed that they were quite aware or very aware of patients' unreimbursed costs. the tests and treatments that they recommend to patients, as did 27.3% of surgeons and 34.3% of radiation oncologists.
More than half (about 57%) of medical oncologists and radiation oncologists (55.8%) reported extremely important to save the patient's money, as did 35.3 % of surgeons.
Many of the patients who participated in the survey reported having incurred debt because of their treatment. These patients included 27.1% white, 58.9% black, 33.5% Latina and 28.8% Asian women. Many patients have also reported substantial losses in income and expenses that they attributed to their illness.
About 14% of all patients reported that lost income represented 10% or more of their household income; 17% of patients reported spending 10% or more of their household income on direct medical expenses; and 7% of patients reported spending the same proportion on direct non-medical expenses
. Jagsi and his co-authors note that the unmet needs of patients to engage physicians in discussions of financial problems were commonplace. Of the 945 women who expressed concerns about finances, 679 (72.8%) indicated that physicians and their staff did not help them. Of the 523 patients who wanted to discuss the impact of bad cancer on employment or finances with their clinicians, 283 (55.4%) said that no relevant discussion occurred. had been with their oncologist, primary care providers, social workers or other professionals.
The awareness that financial toxicity exists is not enough – we need to equip providers with tools that they can use to provide meaningful help when needed.
Dr. Reshma Jagsi
"Raising awareness about the existence of financial toxicity is not enough – we need to equip providers with tools that they can use to provide meaningful help when needed" Jagsi said. The study was funded by a grant to the University of Michigan's National Cancer Institute and was supported by the University's shared biostatistical, badytical, and bioinformatic resource. Michigan Cancer Center. Dr. Jagsi has received grants from the National Cancer Institute, the Doris Duke Charitable Foundation and Blue Cross Blue Shield of Michigan and has acted as a paid consultant to Amgen for work outside of this study. Co-authors received research funding from pharmaceutical companies for work done outside of this study.
Cancer. Posted online July 23, 2018. Abstract
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