Levine Cancer Institute, Atrium Health, 1020 Morehead Medical Drive, Charlotte, NC, 28204, USA.
Levine Cancer Institute, Atrium Health, 1021 Morehead Medical Drive, LCI Building 2, Suite 60100, Charlotte, NC, 28204, USA.
Curr Hematol Malig Rep. 2023 Oct;18(5):158-166. doi: 10.1007/s11899-023-00707-6. Epub 2023 Jul 25.
Financial toxicity is a developing research area to quantify the financial stress experienced by patients and caregivers, as well as the mechanisms by which they manage the costs associated with treatment and the very real harms that this stress can inflict upon cancer care. Patients with blood malignancies experience increased costs associated with their diagnosis due to possible inpatient admissions for treatment, frequent office visits, and even more frequent lab evaluations and testing.
Multiple studies have examined the causes and effects of financial toxicity on patient care and outcomes, and there have been several validated tools developed to identify patients experiencing or at risk for financial harm.
However, few studies to date have focused on implementing successful interventions to assist in mitigating financial difficulties for patients diagnosed with hematologic malignancies and their families. In this review, we examine the current literature with an emphasis on levels of care, including providers, systems, and policies. Specifically, we discuss published interventions including physician education about treatment costs, financial navigation in cancer centers, and novel institutional multidisciplinary review of patients' financial concerns. We also discuss the urgent need for societal and governmental interventions to lessen financial distress experienced by these highly vulnerable blood cancer patients.
财务毒性是一个正在发展的研究领域,用于量化患者和护理人员所经历的财务压力,以及他们管理与治疗相关成本的机制,以及这种压力对癌症护理造成的实际危害。患有血液恶性肿瘤的患者由于治疗可能需要住院、频繁的门诊就诊,甚至更频繁的实验室评估和检查,因此会增加与诊断相关的费用。
多项研究已经研究了财务毒性对患者护理和结局的原因和影响,并且已经开发了几种经过验证的工具来识别经历或有财务风险的患者。
然而,迄今为止,很少有研究专注于实施成功的干预措施,以帮助减轻诊断为血液恶性肿瘤的患者及其家属的经济困难。在这篇综述中,我们重点研究了现有的文献,包括护理水平、提供者、系统和政策。具体而言,我们讨论了已发表的干预措施,包括医生对治疗成本的教育、癌症中心的财务导航,以及对患者财务问题的新型机构多学科审查。我们还讨论了社会和政府干预的迫切需要,以减轻这些高度脆弱的血液癌症患者所经历的经济困境。