Anticipatory Guidance: Developing a Patient Navigation Pathway to Reduce the Financial Toxicity of Cancer

Christabel Cheung, Laundette Jones, Haelim Lee, Jordan Bridges, Reginald Seeley, Melissa Vyfhuis, Maria Gianelle, Bria Thomas, Gail Betz, Laurie Waldo, Alan Hirsch, Shana Ntiri
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Abstract

Background: Healthcare providers have an influential role in the experience of financial toxicity among their cancer patients, yet patients commonly report unmet needs and dissatisfaction regarding communication with their providers about financial concerns. Aims: The purpose of this study is to develop a novel financial navigation pathway that leverages existing patient financial services and resources with corresponding patient-centered, community-informed strategies, via study participants, that may be utilized in routine care to reduce financial hardship among cancer patients. Methods: We conducted in-depth interviews (n=50) with 34 cancer patients and 16 cancer care professionals at a National Cancer Institute designated comprehensive cancer center located in a dense urban area of the US between December 2022 to June 2023. Results: Content analyses resulted in emergent themes and representative quotations on experiences of financial hardship within the material, behavioral, and psychosocial domains. Investigators used emergent themes to develop financial strategies and construct a financial navigation pathway to screen patients for and intervene upon the financial toxicity of cancer in routine care. Conclusion: This study followed an innovative approach by constructing a financial navigation pathway tool that follows the oncological workflow at a National Cancer Institute designated comprehensive cancer center. Future research is needed to test the tool’s impact on financial toxicity, cancer outcomes, and other health-related outcomes, and to better understand how much patient navigation is needed to bring about meaningful change.
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预期指导:发展患者导航路径,以减少癌症的财务毒性
背景:医疗保健提供者在其癌症患者的财务毒性体验中发挥着重要作用,但患者通常报告未满足的需求和对与其提供者就财务问题进行沟通的不满。目的:本研究的目的是通过研究参与者开发一种新的财务导航途径,利用现有的患者财务服务和资源以及相应的以患者为中心、社区知情的策略,可以在常规护理中使用,以减少癌症患者的财务困难。方法:我们在2022年12月至2023年6月期间,对位于美国人口密集城市地区的国家癌症研究所指定的综合癌症中心的34名癌症患者和16名癌症护理专业人员进行了深度访谈(n=50)。结果:内容分析产生了关于物质、行为和社会心理领域中经济困难经历的紧急主题和代表性引文。研究人员使用紧急主题来制定财务策略,并构建财务导航路径,以筛查患者并干预常规护理中癌症的财务毒性。结论:本研究采用了一种创新的方法,构建了一个财务导航路径工具,该工具遵循了国家癌症研究所指定的综合癌症中心的肿瘤工作流程。未来的研究需要测试该工具对财务毒性、癌症结果和其他健康相关结果的影响,并更好地了解需要多少患者导航才能带来有意义的改变。
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