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  • 1
    In: Supportive Care in Cancer, Springer Science and Business Media LLC, Vol. 26, No. 4 ( 2018-4), p. 1315-1321
    Type of Medium: Online Resource
    ISSN: 0941-4355 , 1433-7339
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 1463166-0
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  • 2
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2020
    In:  Breast Cancer Research and Treatment Vol. 179, No. 1 ( 2020-01), p. 207-215
    In: Breast Cancer Research and Treatment, Springer Science and Business Media LLC, Vol. 179, No. 1 ( 2020-01), p. 207-215
    Type of Medium: Online Resource
    ISSN: 0167-6806 , 1573-7217
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2004077-5
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  • 3
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 6_Supplement_1 ( 2020-06-01), p. PR07-PR07
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 6_Supplement_1 ( 2020-06-01), p. PR07-PR07
    Abstract: Background: Awareness of the significant financial burden and distress that cancer patients experience (i.e., “financial toxicity”) is gaining traction in the oncology community. While racial differences in cancer care are well documented, less is known about racial variations in the financial impact of cancer care, particularly among patients with costly incurable disease. Using data from a national survey of racially diverse patients with metastatic breast cancer, we examined racial/ethnic patterns in financial burden due to cancer. Methods: We partnered with the Metastatic Breast Cancer Network to conduct a 20-minute online survey of metastatic breast cancer patients over a 2-week period in 2018. Study participants responded to items assessing sociodemographic characteristics, communication with providers regarding costs, financial distress, strategies for managing cancer-related costs, and emotional well-being. We evaluated and compared financial outcomes among Hispanics, non-Hispanic Blacks, and non-Hispanic Whites. Results: Our analysis included 1,119 respondents from 41 states, including 214 Hispanics (19%), 130 non-Hispanic Blacks (12%), and 775 non-Hispanic Whites (69%). Compared with non-Hispanic Whites, Hispanics were more likely to report refusing or delaying treatment due to costs (81% vs. 41%, p & lt;.001), applying for disability (66% vs. 35.1%, p & lt;.001), avoiding treatment for other medical problems (54% vs. 34%, p & lt;.001), and skipping payments on non-medical bills (70% vs. 13%, p & lt;.001). Non-Hispanic Blacks were more likely than non-Hispanic Whites to report refusing or delaying treatment due to costs (91% vs. 41%, p & lt;.001), skipping payments on non-medical bills (32% vs. 13%, p & lt;.001), and being contacted by a collections agency (87% vs. 46%, p & lt;.001). In contrast, non-Hispanic Whites more often reported skipping a vacation to help manage their cancer care costs than Hispanics and non-Hispanic Blacks (46.1% vs. 36.4% vs. 13.8%, respectively, p & lt;.05). Moreover, compared with non-Hispanic Whites and Blacks, Hispanics reported more severe financial distress associated with uncertainty about the cost of their cancer care (6.6% vs. 8.5% vs 47.4%, respectively, p & lt;.001). Conclusions: Racial/ethnic differences exist in financial burden among metastatic breast cancer patients, with patients of color experiencing more financial harm than their White counterparts. Given the negative impact of financial strain on patient well-being and treatment decision-making, and longstanding disparities in cancer outcomes, equity must be a guiding principle in strategies aimed at addressing financial toxicity in cancer patients. This abstract is also being presented as Poster B024. Citation Format: Cleo A. Samuel, Jennifer C. Spencer, Michelle L. Manning, Donald L. Rosenstein, Katherine E. Reeder-Hayes, Jean B. Sellers, Stephanie B. Wheeler. Racial differences in financial toxicity among metastatic breast cancer patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr PR07.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 4
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 6_Supplement_1 ( 2020-06-01), p. B024-B024
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 6_Supplement_1 ( 2020-06-01), p. B024-B024
    Abstract: This abstract is being presented as a short talk in the scientific program. A full abstract is printed in the Proffered Abstracts section (PR07) of the Conference Proceedings. Citation Format: Cleo A. Samuel, Jennifer C. Spencer, Michelle L. Manning, Donald L. Rosenstein, Katherine E. Reeder-Hayes, Jean B. Sellers, Stephanie B. Wheeler. Racial differences in financial toxicity among metastatic breast cancer patients [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B024.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 5
    In: JCO Oncology Practice, American Society of Clinical Oncology (ASCO), Vol. 19, No. 8 ( 2023-08), p. 654-661
    Abstract: Financial navigation services support patients with cancer and address the direct and indirect financial burden of cancer diagnosis and treatment. These services are commonly delivered through a variety of frontline oncology support personnel (FOSP) including navigators, social workers, supportive care providers, and other clinic staff, but the perspective of FOSPs is largely absent from current literature on financial burden in oncology. We surveyed a national sample of FOSPs to understand their perspectives on patient financial burden, resource availability, and barriers and facilitators to assisting patients with cancer-related financial burden. METHODS We used Qualtrics online survey software and recruited participants using multiple professional society and interest group mailing lists. Categorical responses were described using frequencies, distributions of numeric survey responses were described using the median and IQR, and two open-ended survey questions were categorized thematically using a priori themes, allowing additional emergent themes. RESULTS Two hundred fourteen FOSPs completed this national survey. Respondents reported a high awareness of patient financial burden and felt comfortable speaking to patients about financial concerns. Patient assistance resources were commonly available, but only 15% described resources as sufficient for the observed needs. A substantial portion of respondents reported moral distress related to this lack of resources. CONCLUSION FOSPs, who already have requisite knowledge and comfort in discussing patient financial needs, are a critical resource for mitigating cancer-related financial burden. Interventions should leverage this resource but prioritize transparency and efficiency to reduce the administrative and emotional toll on the FOSP workforce and reduce the risk of burnout.
    Type of Medium: Online Resource
    ISSN: 2688-1527 , 2688-1535
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 3005549-0
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  • 6
    In: Cancer Medicine, Wiley, Vol. 12, No. 10 ( 2023-05), p. 11930-11940
    Abstract: Little is known about the heterogeneous nature of financial hardship in younger patients with metastatic disease and the extent to which insurance protects against it. We examine the association between insurance status and multidimensional indicators of financial hardship in a national sample of women with metastatic breast cancer. Methods We conducted a national, retrospective online survey in partnership with the Metastatic Breast Cancer Network. Eligible participants were ≥18 years, diagnosed with metastatic breast cancer, and able to respond in English. We estimated multivariate generalized linear models predicting two distinct dimensions of financial hardship—financial insecurity (the ability to afford care and living costs) and financial distress (the extent of emotional/psychological distress experienced due to costs)—as a function of insurance status. Results Participants responded from 41 states ( N  = 1054; median age: 44 years). Overall, 30% were uninsured. Financial insecurity was more frequently reported by uninsured respondents. In adjusted analyses, uninsured participants were more likely than insured participants to report contact by debt collectors (adjusted risk ratio [aRR]: 2.38 [2.06, 2.76] ) and being unable to meet monthly expenses (aRR: 2.11 [1.68, 2.66]). Financial distress was reported more frequently by insured participants. For example, insured participants were more likely to worry about future financial problems due to cancer and distress about lack of cost transparency. After adjustment, uninsured participants remained about half as likely as insured participants to report financial distress. Conclusions Young adult women with metastatic cancer reported a high burden of financial toxicity. Importantly, insurance does not protect against financial distress; however, the uninsured are the most materially vulnerable.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2659751-2
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  • 7
    In: Trials, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-10-03)
    Abstract: Almost half of the patients with cancer report cancer-related financial hardship, termed “financial toxicity” (FT), which affects health-related quality of life, care retention, and, in extreme cases, mortality. This increasingly prevalent hardship warrants urgent intervention. Financial navigation (FN) targets FT by systematically identifying patients at high risk, assessing eligibility for existing resources, clarifying treatment cost expectations, and working with patients and caregivers to develop a plan to cope with cancer costs. This trial seeks to (1) identify FN implementation determinants and implementation outcomes, and (2) evaluate the effectiveness of FN in improving patient outcomes. Methods The Lessening the Impact of Financial Toxicity (LIFT) study is a multi-site Phase 2 clinical trial. We use a pre-/post- single-arm intervention to examine the effect of FN on FT in adults with cancer. The LIFT trial is being conducted at nine oncology care settings across North Carolina in the United States. Sites vary in geography (five rural, four non-rural), size (21–974 inpatient beds), and ownership structure (governmental, non-profit). The study will enroll 780 patients total over approximately 2 years. Eligible patients must be 18 years or older, have a confirmed cancer diagnosis (any type) within the past 5 years or be living with advanced disease, and screen positive for cancer-related financial distress. LIFT will be delivered by full- or part-time financial navigators and consists of 3 components: (1) systematic FT screening identification and comprehensive intake assessment; (2) connecting patients experiencing FT to financial support resources via trained oncology financial navigators; and (3) ongoing check-ins and electronic tracking of patients’ progress and outcomes by financial navigators. We will measure intervention effectiveness by evaluating change in FT (via the validated Comprehensive Score of Financial Toxicity, or COST instrument) (primary outcome), as well as health-related quality of life (PROMIS Global Health Questionnaire), and patient-reported delayed or forgone care due to cost. We also assess patient- and stakeholder-reported implementation and service outcomes post-intervention, including uptake, fidelity, acceptability, cost, patient-centeredness, and timeliness. Discussion This study adds to the growing evidence on FN by evaluating its implementation and effectiveness across diverse oncology care settings. Trial registration ClinicalTrials.gov NCT04931251. Registered on June 18, 2021.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2040523-6
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