Impact of a Comprehensive Financial Navigation Intervention to Reduce Cancer-Related Financial Toxicity.

IF 14.8 2区医学 Q1 ONCOLOGY Journal of the National Comprehensive Cancer Network Pub Date : 2024-10-01 DOI:10.6004/jnccn.2024.7030

Stephanie B Wheeler, Michelle L Manning, Mindy Gellin, Neda Padilla, Lisa P Spees, Caitlin B Biddell, Victoria Petermann, Allison Deal, Cindy Rogers, Julia Rodriguez-O'Donnell, Cleo Samuel-Ryals, Katherine Reeder-Hayes, Donald L Rosenstein

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Abstract

Background: Although the need to reduce the impact of financial toxicity among patients with cancer is widely acknowledged, few interventions have been developed to address this issue. We tested a novel, multiphase, patient-centered financial navigation (FN) intervention at a large academic medical center.

Methods: We developed a financial toxicity screening tool consisting of the Comprehensive Score for Financial Toxicity (COST) measure plus several additional items based on patient feedback. After systematizing the screening process, 50 patients from the North Carolina Basnight Cancer Hospital were enrolled in the FN intervention following a positive screen for financial distress (COST score <23). The FN intervention involved one-on-one consultations with a trained financial navigator and included an initial comprehensive intake appointment to determine patient eligibility for financial assistance and follow-up appointments to discuss paperwork and application(s) status. We assessed preliminary intervention effectiveness (preintervention and postintervention COST scores) and implementation (ie, fidelity, uptake, acceptability).

Results: All 50 patients assessed for study eligibility screened positive for financial distress. A total of 46 patients completed both the preintervention and postintervention COST instrument and other measures. Postintervention mean COST scores improved from 6.4 at baseline to 13.3 post-FN (P<.0001), indicating a significant decrease in perceived financial toxicity. Fidelity to the intervention was high and 96% of participants received financial assistance.

Conclusions: A patient-centered FN intervention fully integrated into an existing care coordination model can help to decrease the burden of cancer-related financial toxicity among patients with cancer experiencing financial distress. Further studies are needed to test FN interventions in various oncology settings and among targeted populations.

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综合财务导航干预对减少癌症相关财务毒性的影响。

背景：尽管人们普遍认为有必要降低癌症患者的经济毒性影响，但很少有干预措施能够解决这一问题。我们在一家大型学术医疗中心测试了一种新颖的、多阶段的、以患者为中心的财务导航（FN）干预措施：方法：我们开发了一种财务毒性筛查工具，该工具由财务毒性综合评分（COST）和几个基于患者反馈的附加项目组成。将筛查过程系统化后，北卡罗来纳州巴斯奈特癌症医院的 50 名患者在财务困境筛查（COST 评分结果）呈阳性后被纳入 FN 干预：所有 50 名接受研究资格评估的患者均通过了财务困境筛查。共有 46 名患者完成了干预前和干预后的 COST 工具和其他测量。干预后的平均 COST 得分从基线时的 6.4 分提高到 FN 后的 13.3 分（结论：以患者为中心的 FN 干预措施与其他干预措施相结合，能有效减轻患者的经济压力：以患者为中心的 FN 干预措施完全融入了现有的护理协调模式，有助于减轻经济窘迫的癌症患者与癌症相关的经济负担。需要进一步开展研究，以测试在各种肿瘤环境和目标人群中采取的 FN 干预措施。

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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来源期刊

Journal of the National Comprehensive Cancer Network ONCOLOGY-

CiteScore

20.20

自引率

0.00%

发文量

388

审稿时长

4-8 weeks

期刊介绍： JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.