Financial-legal navigation reduces financial toxicity of pediatric, adolescent, and young adult cancers.

IF 3.4 Q2 ONCOLOGY JNCI Cancer Spectrum Pub Date : 2024-04-30 DOI:10.1093/jncics/pkae025

Jean Edward, Kimberly D Northrip, Mary Kay Rayens, Andrea Welker, Rachel O'Farrell, Jennifer Knuf, Haafsah Fariduddin, Julia Costich, John D'Orazio

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Abstract

Background: Pediatric, adolescent, and young adult patients with cancer and their caregivers are at high risk of financial toxicity, and few evidence-based oncology financial and legal navigation programs exist to address it. We tested the feasibility, acceptability, and preliminary effectiveness of Financial and Insurance Navigation Assistance, a novel interdisciplinary financial and legal navigation intervention for pediatric, adolescent and young adult patients and their caregivers.

Methods: We used a single-arm feasibility and acceptability trial design in a pediatric hematology and oncology clinic and collected preintervention and postintervention surveys to assess changes in financial toxicity (3 domains: psychological response/Comprehensive Score for Financial Toxicity [COST], material conditions, and coping behaviors); health-related quality of life (Patient-Reported Outcomes Measurement Information System Physical and Mental Health, Anxiety, Depression, and Parent Proxy scales); and perceived feasibility, acceptability, and appropriateness.

Results: In total, 45 participants received financial navigation, 6 received legal navigation, and 10 received both. Among 15 adult patients, significant improvements in FACIT-COST (P = .041) and physical health (P = .036) were noted. Among 46 caregivers, significant improvements were noted for FACIT-COST (P < .001), the total financial toxicity score (P = .001), and the parent proxy global health score (P = .0037). We were able to secure roughly $335 323 in financial benefits for 48 participants. The intervention was rated highly for feasibility, acceptability, and appropriateness.

Conclusions: Integrating financial and legal navigation through Financial and Insurance Navigation Assistance was feasible and acceptable and underscores the benefit of a multidisciplinary approach to addressing financial toxicity.

Clinicaltrials.gov registration: NCT05876325.

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财务-法律导航可降低儿科癌症和亚健康癌症的财务毒性。

背景：儿科和青少年癌症患者及护理人员是财务毒性的高危人群，而目前很少有循证的肿瘤财务和法律导航计划来解决这一问题。我们测试了 FINassist（财务和保险导航援助）的可行性、可接受性和初步有效性，这是一项针对儿科肿瘤患者和护理人员的新型跨学科财务和法律导航干预措施：我们在儿科肿瘤学和血液学部门采用了单臂可行性和可接受性试验设计，并收集了干预前后的调查问卷，以评估财务毒性（三个领域：心理反应/财务毒性综合评分[COST]、物质条件和应对行为）、与健康相关的生活质量（PROMIS 身心健康、焦虑、抑郁和家长代理量表）以及感知可行性、可接受性和适当性的变化：45 名参与者接受了财务指导，6 名接受了法律指导，10 名同时接受了财务和法律指导。15 名成年患者的 COST（P=0.041）和身体健康（0.036）均有显著改善。在 46 名护理人员中，COST 有明显改善（结论：通过 FINassist 将财务和法律指导结合起来是可行的、可接受的，并强调了采用多学科方法解决财务毒性问题的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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