Financial toxicity, financial well-being, and quality of life among bladder cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 133-133
Author(s):  
Reginald Tucker-Seeley ◽  
Weizhou Tang ◽  
Leora Steinberg ◽  
Stephanie Banks ◽  
Hilma Bolton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Logistic Regression ◽  
Financial Burden ◽  
Well Being ◽  
Demographic Characteristics ◽  
Financial Toxicity ◽  
Logistic Regression Models ◽  
Long Course

133 Background: Due to a long course of surveillance, and for some patients, multimodal therapy with chemotherapy and surgery, bladder cancer (BC) can present a financial burden to the household. Yet, there are several terms used to describe this burden such as financial hardship and financial toxicity (FT); and it is unclear whether different measures of financial circumstances are correlated and whether they are associated with quality of life (QOL). The goal of this study was to determine whether FT and financial well-being (FWB) were correlated and to determine whether FT and FWB were similarly associated with QOL among BC patients. Methods: Patients that had BC treatment in the last 2 years were recruited from two NCI designated cancer centers for our study (N = 100). The Comprehensive Score for Financial Toxicity (COST) was used to assess FT, the Consumer Financial Protection Bureau’s (CFPB) FWB measure was used to assess FWB, and a BC-specific Functional Assessment of Cancer Therapy (FACT) questionnaire was used to assess physical, social, emotional, and functional domains of QOL. Bivariate analyses were conducted to determine the association among FT, FWB, and QOL; and separate logistic regression analyses predicting FT and FWB were used to determine the association between FT and FWB and each domain of QOL. Results: Bivariate results showed that FT and FWB were highly negatively correlated (r = -.76; p < .0001); however, only FWB was correlated with the total QOL score (p < .05). FT was correlated with physical (p < .01), emotional (p < .05), and functional (p < .05) QOL; and FWB was correlated with physical (p < .05) and functional (p < .05) QOL. Logistic regression models adjusted for socioeconomic and demographic characteristics showed that those reporting higher physical QOL (OR = 1.18; CI: 1.04-1.35) and higher functional QOL (OR = 1. 15; CI: 1.03-1.28) had higher odds of reporting high FWB. Conclusions: Given the surveillance and treatment processes for BC patients, it is important to better understand their financial circumstances as they are navigating and managing care. Our results suggest that physical and functional QOL is relevant for predicting FWB, but after considering socioeconomic and demographic characteristics, no domain of QOL was a significant predictor of FT among BC patients.

scholarly journals A qualitative study on cancer patientś experiences with financial burden and financial distress

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S L Schröder ◽  
N Schumann ◽  
M Richter
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Financial Distress ◽  
Financial Burden ◽  
Well Being ◽  
Money Management ◽  
Financial Toxicity ◽  
Financial Decline ◽  
The Individual

Abstract Background Financial toxicity was hardly examined in the context of public health. It is proven that financial distress following a cancer diagnosis can have an impact on the quality of life and mortality. Additionally, it was found that subjective indicators of financial toxicity have a stronger effect than objective indicators. Nevertheless, less is known about how higher costs can impact on the individual patient’s well-being. The aim of this study was to analyse the major drivers that lead from financial consequences to subjective financial distress in a country with statutory health insurance. Methods Qualitative semi-structured interviews were conducted with 39 cancer patients, aged between 40 and 86 years, in Germany. Inductive content analysis of data was performed and the individual patient's pathways are recently compared and contrasted. Results Above all, we found that financial distress is not only induced by higher costs and lower available money. Moreover, independently of whether patients experienced any financial decline, they experienced making financial adjustments and feeling financially stressed. The preliminary results show that the patient's ability of good money management and trust in one’s own skills being able to get along with less money might predict psychosocial consequences. Conclusions Screening instruments for financial toxicity are important to effectively detect patients whose quality of life might be worsened by their financial situation. It might be that rather financial skills than the amount of costs are important indicators of financial distress. Key messages Even cancer patients experiencing almost no financial decline during the period of cancer treatment might experience lower quality of life caused by financial distress. The ability and trust in oneself money management might have the strongest impact on subjective financial stress.

Physician Perceptions on Quality of Life and Resuscitation Preferences for Extremely Early Newborns

2021 ◽  
Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Mixed Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Comfort Care ◽  
Logistic Regression Models ◽  
Extremely Preterm

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points

Home Infusion of Eculizumab: A Unique and Innovative Model of Drug Delivery to Reduce Treatment-Associated Burden and Enhance Quality of Life for Patients with PNH

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4671-4671
Author(s):  
Louise M Arnold ◽  
Jill Stephenson ◽  
Richard Kelly ◽  
David Buchanan ◽  
Gareth Jones ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bone Marrow ◽  
Financial Burden ◽  
Well Being ◽  
Full Time ◽  
Home Infusion ◽  
The Uk ◽  
Full Time Employment ◽  
At Home

Abstract Paroxysmal Nocturnal Hemoglobinuria (PNH) is an acquired clonal stem cell disease, characterised by intravascular hemolysis, bone marrow failure and lifethreatening thromboses. The median survival is 10–15 years, with the average age of presentation being in the 30’s. Symptoms include hemoglobinuria, fatigue, anemia, venous and arterial thromboses, recurrent pain, renal impairment, erectile dysfunction and pulmonary hypertension. The care of a patient with PNH is complex and challenging, as many experience chronic symptoms with periods of acute exacerbations. Historically the management of PNH included bone marrow transplant, blood transfusion and administration of additional supportive therapies, all necessitating regular visits to the hospital. Eculizumab, a monoclonal antibody that binds to the C5 complement component inhibiting the activity of terminal complement and thus preventing the destruction of red blood cells has dramatically altered the management of hemolytic PNH. Clinical trials of eculizumab demonstrated the resolution of the majority of symptoms and complications of PNH and resulted in its approval in the UK in June 2007. Eculizumab is administered as a 30 minute intravenous infusion every 14 days, and under the terms of its current EU licence, must be administered by a healthcare professional. In view of the rarity of PNH there are relatively few specialist Centres for the disease resulting in, patients travelling long distances for review and treatment. In view of the dramatic improvement in symptoms on eculizumab many patients are able to return to a near normal lifestyle. In the UK, Leeds Teaching Hospitals with Healthcare at Home have developed a home infusion programme that ensures safe administration of eculizumab in the patient’s home at a time convenient to them, leading to enhanced treatment-associated convenience for patients and their families. Patients then only attend the PNH Centre every 3 months to ensure appropriate monitoring and patient education. A recent survey of patients reports a reduction in treatment-associated burden for PNH patients and their families when receiving infusions at home. 46 patients responded to the survey with just over half receiving eculizumab. Of the 21 patients at the time receiving home infusions 19 found this more convenient than the hospital. Home treatment allows flexibility and for some, the return to full-time employment, with the associated financial benefits and improvement in psychological well-being. Of the 21 patients on home care 7 stated there ability to work was transformed with a further 10 having great improvement. Whilst the purpose of the survey was not to address financial burden, the home infusion programme has anecdotally reduced the financial burden on the patient and their family by eliminating the need for time off work, allowing return to full-time employment, and eliminating the cost of travel to and from the hospital for treatments. No patients reporting negative impact, including effect on social life and family relationships, whilst 15 experienced improvement or complete transformation in both areas. The patients reported confidence in the homecare programme, knowing that a very close working relationship existed between the expert hospital and homecare teams. This innovative programme of medication delivery by a dedicated home nursing team allows patients who have previously struggled to cope with their illness to lead a near normal life with an associated enhancement in quality of life. Patients are able to carry on with activities of daily life, including work, recreational activities and holidays, whilst at the same time ensuring compliance with treatment and therefore allowing maximum therapeutic benefit.

Relationship between financial toxicity and health-related quality of life in patients with advanced solid tumors.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 31-31
Author(s):  
Jonas A. De Souza ◽  
Bonnie J. Yap
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Tumor Type ◽  
Financial Toxicity ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
The Cost

31 Background: Financial toxicity is an important Patient-Reported Outcome (PRO). Its relationship with health-related quality of life (HRQOL) has not been previously described. Therefore, we report the relationship between financial toxicity and health-related quality of life (HRQOL) in patients with advanced cancers. Methods: The global HRQOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G) and its subscales Physical Well-Being (PWB), Social/Family Well-Being (SWB), Emotional Well-Being (EWB) and Functional Well-Being (FWB). Financial toxicity was assessed by the COST (COmprehensive Score for financial Toxicity), a PRO measure previously developed in 155 patients with advanced cancers. Correlations were calculated using Spearman's correlation. Subject data on tumor type, age, gender, race, income, insurance type and educational level were collected. Results: Fifty patients were assessed. All participants were diagnosed with advanced cancers, were receiving treatment at the time of participation, and had received treatment for at least 3 months. The median COST was 22 (range 0-44), and mean 22.51 (s.d. ±10.80). A negative correlation existed between the COST and HRQOL as measured by the FACT-G (r = -0.47, P <.001), and its subscales: PWB (r=-0.35, p < 0.05), SWB (r=-0.33, p < 0.05), EWB (r=-0.32, p < 0.05) and FWB (r=-0.41, p < 0.01). In this small sample, there were no correlations between the COST and sociodemographic characteristics. Conclusions: Results demonstrate an inverse relationship between patient-reported HRQOL and financial toxicity, suggesting that higher financial toxicity is associated with worse HRQOL. A larger study is in progress to identify cancer patients at higher risk of financial toxicity.

MP86-05 THE RELATIONSHIP BETWEEN FINANCIAL TOXICITY AND QUALITY OF LIFE AMONG BLADDER CANCER PATIENTS

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Marianne Casilla-Lennon ◽  
Seul Ki Cho ◽  
Allison Deal ◽  
Gopal Narang ◽  
Jeannette Bensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Financial Toxicity ◽  
The Relationship

scholarly journals Financial burden impact quality of life among Lymphatic Filariasis Patients

2021 ◽  
Author(s):  
Samuel Opoku Asiedu ◽  
Alexander Kwarteng ◽  
Emmanuel Kobla Atsu Amewu ◽  
Priscilla Kini ◽  
Bill Clinton Aglomasa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lymphatic Filariasis ◽  
Financial Burden ◽  
Pearson Correlation ◽  
Well Being ◽  
P Value ◽  
Life Questionnaire ◽  
Financial Condition ◽  
Study Participants

Abstract BackgroundHuman lymphatic filarial pathology is the leading cause of disability and poverty among people living with the infection. The second goal of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to manage the disease's morbidity to improve patients' quality of life. Consequently, the current study assessed the overall quality of life of lymphatic filariasis (LF) pathology patients in some selected endemic communities in rural Ghana. MethodIn the present study, the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) was used to evaluate the effect of lymphatic filariasis on the quality of life of people, with the disease in nine (9) communities in the Ahanta West District of the Western Region of Ghana where mass drug administration is being implemented for the past twenty years. Pearson’s correlation, linear regression, and one-way analysis of variance (ANOVA) analyses were used to assess the associations between the LFSQQ instrument domains.ResultsOf the 155 study participants recruited, 115 (74.19%) were females, and 40 (25.81%) males. A greater proportion of the study participants (40, 25.8%) were presented with stage two (2) lymphoedema, while only two patients had stage seven (7) lymphoedema. The average of the overall quality of life scores of study participants was 68.24. There was a negative Pearson correlation (r = -0.504, p-value < 0.001) between the stage of lymphoedema (severity of the disease) and the quality of life of the LF patients. In addition, a clear pattern of positive correlation (r = 0.71, p-value < 0.001) was observed between the disease burden and pain/discomfort domains of the study participants. Whereas the highest domain-specific score (85.03) was observed in the domain of self-care, we noted that the environmental domain, which consists of the financial status, was the lowest (45.94) among the study participants. ConclusionOur findings support previous works on the reduced quality of life among lymphatic filariasis patients with pathology. In this study, our results reveal a depressing financial condition among people presenting with late stages of LF pathologies, which eventually reduces their well-being.

Identifying patients at risk for nonroutine discharge after surgery for cervical myelopathy: an analysis from the Quality Outcomes Database

2021 ◽  
pp. 1-9
Author(s):  
Praveen V. Mummaneni ◽  
Mohamad Bydon ◽  
John J. Knightly ◽  
Mohammed Ali Alvi ◽  
Yagiz U. Yolcu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
African American ◽  
Cervical Myelopathy ◽  
Demographic Characteristics ◽  
Quality Outcomes ◽  
Factors Associated ◽  
Multivariable Logistic Regression ◽  
Predictor Importance

OBJECTIVE Optimizing patient discharge after surgery has been shown to impact patient recovery and hospital/physician workflow and to reduce healthcare costs. In the current study, the authors sought to identify risk factors for nonroutine discharge after surgery for cervical myelopathy by using a national spine registry. METHODS The Quality Outcomes Database cervical module was queried for patients who had undergone surgery for cervical myelopathy between 2016 and 2018. Nonroutine discharge was defined as discharge to postacute care (rehabilitation), nonacute care, or another acute care hospital. A multivariable logistic regression predictive model was created using an array of demographic, clinical, operative, and patient-reported outcome characteristics. RESULTS Of the 1114 patients identified, 11.2% (n = 125) had a nonroutine discharge. On univariate analysis, patients with a nonroutine discharge were more likely to be older (age ≥ 65 years, 70.4% vs 35.8%, p < 0.001), African American (24.8% vs 13.9%, p = 0.007), and on Medicare (75.2% vs 35.1%, p < 0.001). Among the patients younger than 65 years of age, those who had a nonroutine discharge were more likely to be unemployed (70.3% vs 36.9%, p < 0.001). Overall, patients with a nonroutine discharge were more likely to present with a motor deficit (73.6% vs 58.7%, p = 0.001) and more likely to have nonindependent ambulation (50.4% vs 14.0%, p < 0.001) at presentation. On multivariable logistic regression, factors associated with higher odds of a nonroutine discharge included African American race (vs White, OR 2.76, 95% CI 1.38–5.51, p = 0.004), Medicare coverage (vs private insurance, OR 2.14, 95% CI 1.00–4.65, p = 0.04), nonindependent ambulation at presentation (OR 2.17, 95% CI 1.17–4.02, p = 0.01), baseline modified Japanese Orthopaedic Association severe myelopathy score (0–11 vs moderate 12–14, OR 2, 95% CI 1.07–3.73, p = 0.01), and posterior surgical approach (OR 11.6, 95% CI 2.12–48, p = 0.004). Factors associated with lower odds of a nonroutine discharge included fewer operated levels (1 vs 2–3 levels, OR 0.3, 95% CI 0.1–0.96, p = 0.009) and a higher quality of life at baseline (EQ-5D score, OR 0.43, 95% CI 0.25–0.73, p = 0.001). On predictor importance analysis, baseline quality of life (EQ-5D score) was identified as the most important predictor (Wald χ2 = 9.8, p = 0.001) of a nonroutine discharge; however, after grouping variables into distinct categories, socioeconomic and demographic characteristics (age, race, gender, insurance status, employment status) were identified as the most significant drivers of nonroutine discharge (28.4% of total predictor importance). CONCLUSIONS The study results indicate that socioeconomic and demographic characteristics including age, race, gender, insurance, and employment may be the most significant drivers of a nonroutine discharge after surgery for cervical myelopathy.

scholarly journals Financial Toxicity among Patients with Bladder Cancer: Reasons for Delay in Care and Effect on Quality of Life

2018 ◽  
Vol 199 (5) ◽  
pp. 1166-1173 ◽  
Author(s):  
Marianne M. Casilla-Lennon ◽  
Seul Ki Choi ◽  
Allison M. Deal ◽  
Jeannette T. Bensen ◽  
Gopal Narang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Financial Toxicity

scholarly journals Ordinal logistic regression models: application in quality of life studies

2008 ◽  
Vol 24 (suppl 4) ◽  
pp. s581-s591 ◽  
Author(s):  
Mery Natali Silva Abreu ◽  
Arminda Lucia Siqueira ◽  
Clareci Silva Cardoso ◽  
Waleska Teixeira Caiaffa
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Goodness Of Fit ◽  
Ordinal Logistic Regression ◽  
Proportional Odds Model ◽  
Outcome Variable ◽  
Proportional Odds ◽  
Logistic Regression Models

Quality of life has been increasingly emphasized in public health research in recent years. Typically, the results of quality of life are measured by means of ordinal scales. In these situations, specific statistical methods are necessary because procedures such as either dichotomization or misinformation on the distribution of the outcome variable may complicate the inferential process. Ordinal logistic regression models are appropriate in many of these situations. This article presents a review of the proportional odds model, partial proportional odds model, continuation ratio model, and stereotype model. The fit, statistical inference, and comparisons between models are illustrated with data from a study on quality of life in 273 patients with schizophrenia. All tested models showed good fit, but the proportional odds or partial proportional odds models proved to be the best choice due to the nature of the data and ease of interpretation of the results. Ordinal logistic models perform differently depending on categorization of outcome, adequacy in relation to assumptions, goodness-of-fit, and parsimony.

scholarly journals Financial burden impact quality of life among lymphatic Filariasis patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Opoku Asiedu ◽  
Alexander Kwarteng ◽  
Emmanuel Kobla Atsu Amewu ◽  
Priscilla Kini ◽  
Bill Clinton Aglomasa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lymphatic Filariasis ◽  
Financial Burden ◽  
Pearson Correlation ◽  
Well Being ◽  
Life Questionnaire ◽  
Financial Condition ◽  
Severity Of The Disease ◽  
Study Participants

Abstract Background Human lymphatic filarial pathology is the leading cause of disability and poverty among people living with the infection. The second goal of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to manage the disease’s morbidity to improve patients’ quality of life. Consequently, the current study assessed the overall quality of life of lymphatic filariasis (LF) pathology patients in some selected endemic communities in rural Ghana. Method In the present study, the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) was used to evaluate the effect of lymphatic filariasis on the quality of life of people, with the disease in nine (9) communities in the Ahanta West District of the Western Region of Ghana where mass drug administration is being implemented for the past twenty years. Pearson’s correlation, linear regression, and one-way analysis of variance (ANOVA) analyses were used to assess the associations between the LFSQQ instrument domains. Results Of the 155 study participants recruited, 115 (74.19%) were females, and 40 (25.81%) males. A greater proportion of the study participants (40, 25.8%) were presented with stage two (2) lymphoedema, while only two patients had stage seven (7) lymphoedema. The average of the overall quality of life scores of study participants was 68.24. There was a negative Pearson correlation (r = − 0.504, p-value < 0.001) between the stage of lymphoedema (severity of the disease) and the quality of life of the LF patients. In addition, a clear pattern of positive correlation (r = 0.71, p-value < 0.001) was observed between the disease burden and pain/discomfort domains of the study participants. Whereas the highest domain-specific score (85.03) was observed in the domain of self-care, we noted that the environmental domain, which consists of the financial status, was the lowest (45.94) among the study participants. Conclusion Our findings support previous works on the reduced quality of life among lymphatic filariasis patients with pathology. In this study, our results reveal a depressing financial condition among people presenting with late stages of LF pathologies, which eventually reduces their well-being.

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