癌症幸存者对减轻癌症治疗相关经济毒性的干预措施的时间和内容的偏好。
Cancer survivor preferences on the timing and content of interventions to mitigate financial toxicity associated with cancer treatment.
机构信息
Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA.
Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, Georgetown University, Washington, DC, USA.
出版信息
Support Care Cancer. 2024 Nov 8;32(12):778. doi: 10.1007/s00520-024-08983-5.
PURPOSE
Despite growing research on financial toxicity among cancer survivors, large gaps remain in understanding how to intervene to minimize financial toxicity. Uptake and efficacy of interventions mitigating cancer financial toxicity, though promising, remain limited and inconsistent. To date, survivor preferences for financial toxicity interventions are underexplored. This study aimed to evaluate survivor preferences for timing and content of a survivor-facing intervention to address financial toxicity.
METHODS
Adult survivors (N = 105) of colorectal cancer (N = 55) or Non-Hodgkin Lymphoma (N = 50) from three tertiary care centers self-reported demographic and clinical characteristics, comorbidities, mental health, financial impact of cancer (Comprehensive Score for Financial Toxicity scale), and preferences for intervention timing and content. Chi-square tests examined associations between intervention timing and content preferences with financial toxicity score. ANOVAs and correlation analyses described associations between the number of intervention components survivors endorsed and survivors' characteristics.
RESULTS
Regarding intervention timing, 79% of survivors favored intervention before treatment. The most frequently endorsed content was understanding out-of-pocket costs and insurance (48.6%) and applying for aid (39%). Survivors experiencing higher financial toxicity reported greater interest in all intervention components. Survivors with colorectal cancer (p = .018), < 65 years (p = .019), higher financial toxicity (p < .001), greater life-altering (p < .001) and care-altering (p = .014) coping behaviors, and poorer mental health (p = .008) endorsed more intervention components.
CONCLUSIONS
Actionable insights to improve financial toxicity interventions may be to offer assistance earlier than currently provided (i.e. before treatment) and to include certain topics currently rarely offered (e.g., stress management, budget development support) in line with survivors' preferences.
目的
尽管针对癌症幸存者的财务毒性的研究不断增加，但在如何进行干预以最大程度地减少财务毒性方面仍存在很大差距。尽管减轻癌症财务毒性的干预措施具有很大的潜力，但它们的应用和效果仍有限且不一致。迄今为止，对幸存者对财务毒性干预措施的偏好仍研究不足。本研究旨在评估针对癌症幸存者的干预措施对财务毒性的接受程度和效果，以及幸存者对该干预措施的时机和内容的偏好。
方法
来自三家三级护理中心的 105 名成年癌症幸存者（55 名结直肠癌幸存者，50 名非霍奇金淋巴瘤幸存者）报告了人口统计学和临床特征、合并症、心理健康、癌症对财务的影响（全面财务毒性评分），以及对干预时机和内容的偏好。卡方检验用于检验干预时机和内容偏好与财务毒性评分之间的关系。方差分析和相关分析描述了幸存者支持的干预组件数量与幸存者特征之间的关系。
结果
79%的幸存者倾向于在治疗前接受干预。最常被提及的内容是了解自付费用和保险（48.6%）和申请援助（39%）。经历更高财务毒性的幸存者对所有干预内容的兴趣更大。患有结直肠癌的幸存者（p = .018）、<65 岁的幸存者（p = .019）、财务毒性更高的幸存者（p < .001）、生活改变（p < .001）和治疗改变（p = .014）应对行为更多的幸存者，以及心理健康状况更差的幸存者（p = .008），更倾向于选择更多的干预组件。
结论
根据幸存者的偏好，提高财务毒性干预措施的可操作性建议可能是提供更早的帮助（即在治疗前），并纳入一些目前很少提供的主题（例如，压力管理，预算制定支持）。
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