Patient-reported financial toxicity and adverse medical consequences in head and neck cancer.
Ontology highlight
ABSTRACT: Objectives
Financial toxicity (FT) is a significant barrier to high-quality cancer care, and patients with head and neck cancer (HNCA) are particularly vulnerable given their need for intensive support, daily radiotherapy (RT), and management of long-term physical, functional, and psychosocial morbidities following treatment. We aim to identify predictors of FT and adverse consequences in HNCA following RT.Materials and methods
We performed a prospective survey study of patients with HNCA seen in follow-up at an academic comprehensive cancer center (CCC) or Veterans Affairs hospital between 05/2016 and 06/2018. Surveys included validated patient-reported functional outcomes and the COST measure, a validated instrument for measuring FT.Results
The response rate was 86% (n = 63). Younger age and lower median household income by county were associated with lower COST scores (i.e., worse FT) on multivariable analysis (p = .045 and p = .016, respectively). Patients with worse FT were more likely to skip clinic visits (RR (95% CI) 2.13 (1.23-3.67), p = .007), be noncompliant with recommended supplements or medications (1.24 (1.03-1.48), p = .02), and require supportive infusions (1.10 (1.02-1.20), p = .02). At the CCC, patients with worse FT were more likely to require feeding tubes (1.62 (1.14-2.31), p = .007). Overall, 36% reported that costs were higher than expected, 48% were worried about paying for treatment, and 33% reported at least a moderate financial burden from treatment.Conclusion
HNCA patients experience substantial FT from their diagnosis and/or therapy, with potential implications for medical compliance, QOL, and survivorship care.
SUBMITTER: Beeler WH
PROVIDER: S-EPMC7008081 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Publications
Patient-reported financial toxicity and adverse medical consequences in head and neck cancer.
Beeler Whitney H WH Bellile Emily L EL Casper Keith A KA Jaworski Elizabeth E Burger Nicholas J NJ Malloy Kelly M KM Spector Matthew E ME Shuman Andrew G AG Rosko Andrew A Stucken Chaz L CL Chinn Steven B SB Dragovic Aleksandar F AF Chapman Christina H CH Owen Dawn D Jolly Shruti S Bradford Carol R CR Prince Mark E P MEP Worden Francis P FP Jagsi Reshma R Mierzwa Michelle L ML Swiecicki Paul L PL
Oral oncology 20191223
<h4>Objectives</h4>Financial toxicity (FT) is a significant barrier to high-quality cancer care, and patients with head and neck cancer (HNCA) are particularly vulnerable given their need for intensive support, daily radiotherapy (RT), and management of long-term physical, functional, and psychosocial morbidities following treatment. We aim to identify predictors of FT and adverse consequences in HNCA following RT.<h4>Materials and methods</h4>We performed a prospective survey study of patients ...[more]
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