Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd, Suite BG20, Atlanta, GA, 30322, USA.
Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, GA, USA.
Support Care Cancer. 2022 Oct;30(10):8173-8182. doi: 10.1007/s00520-022-07270-5. Epub 2022 Jul 7.
We conducted a pilot study assessing the feasibility of a personalized out-of-pocket cost communication, remote financial navigation, and counseling (CostCOM) intervention in cancer patients.
Twenty-three adult, newly diagnosed cancer patients at a single community oncology practice were asked to complete a survey and participate in a CostCOM intervention, including patient-specific out-of-pocket cost communication, remote financial navigation, and counseling. Feasibility was defined as patient participation in CostCOM, and its impact on financial worry measured using the Comprehensive Score for Financial Toxicity (COST) (higher score = less worry) was assessed. Eight patients' and two providers' experience with CostCOM was evaluated using qualitative interviews.
Mean patient age was 61 (78.3% female; 100% white). Of 23 CostCOM patients, 86.9% completed CostCOM, 60% of them completed a financial assistance application, and 25% of those who applied were enrolled in a co-pay assistance program. Patients' financial worry significantly improved following CostCOM (COST score of 10.0 ± 9.6 at enrollment vs. 16.9 ± 8.1 at follow-up; p < 0.001). Mean general satisfaction (out of 5) with CostCOM was 4.1 ± 0.7. In qualitative interviews following OOPC communication, 75% felt a positive impact on their mental health, and all patients reported no change in their treatment plan; 83.3% found financial navigation beneficial. In providers' interviews, buy-in from relevant stakeholders, integration of the CostCOM with existing workflow, and larger studies to assess the effectiveness of CostCOM were identified as factors needed for CostCOM implementation in practice.
CostCOM interventions are feasible and acceptable and decrease financial worry in patients with cancer.
我们开展了一项试点研究，评估了在癌症患者中实施个性化自付费用沟通、远程财务导航和咨询（CostCOM）干预的可行性。
在一家社区肿瘤诊所，我们邀请了 23 名新确诊的成年癌症患者完成一项调查并参与 CostCOM 干预，包括患者特定的自付费用沟通、远程财务导航和咨询。可行性定义为患者参与 CostCOM，使用综合财务毒性评分（COST）评估其对财务担忧的影响（得分越高，担忧越少）。采用定性访谈评估 8 名患者和 2 名提供者对 CostCOM 的体验。
患者平均年龄为 61 岁（78.3%为女性；100%为白人）。在 23 名 CostCOM 患者中，86.9%完成了 CostCOM，其中 60%完成了财务援助申请，25%申请的患者被纳入共付援助计划。CostCOM 后患者的财务担忧显著改善（COST 得分从入组时的 10.0±9.6 降至随访时的 16.9±8.1；p<0.001）。CostCOM 的总体满意度（满分 5 分）平均为 4.1±0.7。在自付费用沟通后的定性访谈中，75%的患者表示对其心理健康有积极影响，所有患者均表示治疗计划无变化；83.3%的患者认为财务导航有益。在提供者访谈中，相关利益相关者的认可、将 CostCOM 与现有工作流程整合，以及开展更大规模的研究以评估 CostCOM 的有效性，被确定为 CostCOM 在实践中实施所需的因素。
CostCOM 干预措施可行且可接受，可降低癌症患者的财务担忧。
