Financial assistance programs for cancer patients

Background： The high costs of oncology care can lead to financial stress and have deleterious effects on the well-being of patients and their families. However, only a handful of financial assistance programs for cancer patients have been implemented and evaluated to date. Recent findings： Key features of reported programs include instrumental support through financial navigation or education for patients, and financial or charitable support for healthcare costs. Only one of the programs successfully reduced actual out-of-pocket costs for patients, though others were associated with psychosocial benefits or increased knowledge of financial resources. Four of the 5 programs evaluated to date were pilot studies with small sample sizes, and most lack control groups for comparison. Conclusions. Additional studies are needed that include larger sample sizes and with comparison groups of cancer patients in order to determine whether the counseling and navigator programs are effective in addressing financial distress in this patient population. Of particular interest are programs designed for low-income patients and those who lack health care insurance. Financial assistance programs that implement solutions at different levels of the healthcare system (individual patients, providers, healthcare institutions) are more likely to be effective. Multi-level interventions are needed that address the systems in which patients access care, the actual costs of services and drugs, and the individual needs of patients in order to reduce financial hardship for cancer patients.

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Ovarian cancer patients’ perspectives on facilitators and barriers to accessing financial assistance.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.64 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 64-64

Author(s):

Margaret Irene Liang ◽

Janice Leahgrace Simons ◽

Ivan I. Herbey ◽

Jaclyn Wall ◽

Lindsay Rucker ◽

...

Keyword(s):

Ovarian Cancer ◽

Cancer Patients ◽

Financial Distress ◽

Financial Assistance ◽

Financial Toxicity ◽

Assistance Programs ◽

Patient Reported ◽

Facilitators And Barriers ◽

Inductive Thematic Analysis ◽

Patients Perspective

64 Background: Our aim was to obtain ovarian cancer patients’ perspective on accessing financial assistance programs. Methods: We recruited ovarian cancer patients receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Two interviewers conducted 45-minute interviews on the costs of care, which were recorded and transcribed. Three coders used inductive thematic analysis to identify themes. Results: There were 18 of 22 interviews currently evaluable. Median age was 57 and 68% of participants reported income <$40,000. Facilitators and barriers to accessing financial assistance are shown in the table below. Conclusions: Patients’ reliance on existing support systems and cancer organizations highlight a need for health systems to leverage these relationships and improve organized efforts to provide information related to financial assistance. Proactively asking about financial needs and providing resources to all patients, regardless of income, may mitigate patient reported barriers to accessing financial assistance. [Table: see text]

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Multiple Losses: The Psychological and Economic Well-Being of Survivors of Intimate Partner Violence

Journal of Interpersonal Violence ◽

10.1177/0886260517706760 ◽

2017 ◽

Vol 35 (15-16) ◽

pp. 3054-3078 ◽

Cited By ~ 3

Author(s):

Elizabeth W. Sauber ◽

Karen M. O’Brien

Keyword(s):

Intimate Partner Violence ◽

Low Income ◽

Partner Violence ◽

Financial Distress ◽

Male Partner ◽

Well Being ◽

Intimate Partner ◽

Hierarchical Regression ◽

Conservation Of Resources ◽

Resource Loss

This study advanced knowledge regarding the mechanisms through which intimate partner violence relates to psychological and financial distress with a sample of diverse low-income women. Data were collected from 147 female domestic violence survivors who were abused by a male partner within the past 6 months. Three hierarchical regression analyses revealed that psychological, physical, and economic abuse were predictive of posttraumatic stress, depression, and economic self-sufficiency among survivors. Guided by the Conservation of Resources Theory, the loss of financial, work, and interpersonal resources also predicted these three outcomes, above and beyond abuse experiences (i.e., economically controlling behaviors, economic sabotage, and interpersonal resource loss were unique predictors). In addition, bootstrap mediation analyses showed that interpersonal resource loss partially mediated the relationship between psychological abuse and mental health outcomes. Together, these findings can be used to inform future interventions to promote the financial and psychological well-being of survivors.

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The significance of DOHaD for Small Island Developing States

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174418000466 ◽

2018 ◽

Vol 9 (5) ◽

pp. 487-491 ◽

Cited By ~ 5

Author(s):

S. Tu’akoi ◽

M. H. Vickers ◽

K. Tairea ◽

Y. Y. M. Aung ◽

N. Tamarua-Herman ◽

...

Keyword(s):

Early Life ◽

Disease Risk ◽

Communicable Disease ◽

Adult Population ◽

Well Being ◽

Small Sample ◽

Small Island ◽

Sample Sizes ◽

Small Island Developing States ◽

The Impact

AbstractSmall Island Developing States (SIDS) are island nations that experience specific social, economic and environmental vulnerabilities associated with small populations, isolation and limited resources. Globally, SIDS exhibit exceptionally high rates of non-communicable disease (NCD) risk and incidence. Despite this, there is a lack of context-specific research within SIDS focused on life course approaches to NCD prevention, particularly the impact of the early-life environment on later disease risk as defined by the Developmental Origins of Health and Disease (DOHaD) framework. Given that globalization has contributed to significant nutritional transitions in these populations, the DOHaD paradigm is highly relevant. SIDS in the Pacific region have the highest rates of NCD risk and incidence globally. Transitions from traditional foods grown locally to reliance on importation of Western-style processed foods high in fat and sugar are common. The Cook Islands is one Pacific SIDS that reports this transition, alongside rising overweight/obesity rates, currently 91%/72%, in the adult population. However, research on early-life NCD prevention within this context, as in many low- and middle-income countries, is scarce. Although traditional research emphasizes the need for large sample sizes, this is rarely possible in the smaller SIDS. In these vulnerable, high priority countries, consideration should be given to utilizing ‘small’ sample sizes that encompass a high proportion of the total population. This may enable contextually relevant research, crucial to inform NCD prevention strategies that can contribute to improving health and well-being for these at-risk communities.

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The Effect of Mood on Judgments of Subjective Well-Being: Nine Tests of the Judgment Model

10.31234/osf.io/5fj9c ◽

2016 ◽

Author(s):

Stevie C. Y. Yap ◽

Jessica Wortman ◽

Ivana Anusic ◽

S. Glenn Baker ◽

Laura Danielle Scherer ◽

...

Keyword(s):

Life Satisfaction ◽

Well Being ◽

Small Sample ◽

Subjective Well Being ◽

Sample Sizes ◽

Small Sample Sizes ◽

Highly Cited

Life satisfaction judgments are thought to represent an overall evaluationof the quality of a person’s life as a whole. Thus, they should reflectrelatively important and stable characteristics of that person’s life.Previous highly cited research has suggested that transient factors, suchas the mood that a person experiences at the time that well-being judgmentsare made, can influence these judgments. However, most existing studiesused small sample sizes, and few replications have been attempted. Ninedirect and conceptual replications of past studies testing the effects ofmood on life satisfaction judgments were conducted using sample sizes thatwere considerably larger than previous studies (Ns = 202, 200, 269, 118,320, 401, 285, 129, 122). Most of the nine studies resulted innonsignificant effects on life satisfaction and happiness judgments, andthose that were significant were substantially smaller than effects foundin previous research.______________________________________

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Trends in Financial Toxicity for Patients of a Community Cancer Clinic

Blood ◽

10.1182/blood.v126.23.2124.2124 ◽

2015 ◽

Vol 126 (23) ◽

pp. 2124-2124

Author(s):

Cherupolil R. Santhosh-Kumar ◽

Stephanie Struve ◽

Sue Freier

Keyword(s):

Financial Distress ◽

Conflicts Of Interest ◽

Tertiary Care ◽

Financial Assistance ◽

Financial Strain ◽

Financial Toxicity ◽

Assistance Programs ◽

Number Of Patients ◽

Cancer Clinic ◽

Over Time

Abstract Background: Rising health care costs - especially those of new medications for cancer treatment - have caused a severe financial strain on patients, leading to significant alteration of lifestyles. Published information regarding financial distress is scant with data only from large tertiary care institutions that may not be relevant to smaller communities. We sought to analyze the extent of financial toxicity over time in a community cancer clinic staffed by two medical oncologists. Methods: Since 2010, a team of two oncology social workers prospectively collected data on financial assistance for patients treated at our community cancer clinic. Data regarding medication assistance is available for 2012-2014. Results: Approximately 500 new patients and 1600 unique follow-up patients are evaluated and treated at the clinic annually. From January 2010 through December 2014, 1,012 requests for assistance were processed. The number of requests increased from 134 in 2010 to 320 in 2014. Most common requests were for medications and financial aid. Trends are shown in the table. Though the number of patients applying for medication assistance increased in 2014, the amount requested was less than previous years because of the influx of specialty pharmacies in the market with their own assistance programs. Conclusions: Financial toxicity for cancer patients is a real issue in the community clinic setting.Requests for financial assistance have increased over time. The number of FDA approvals for new cancer medications seem to correlate with the increase. Studies are in progress to further clarify the financial impact of cancer on patients.Table.Trends in requests for assistance and aid and FDA approval for new medications.Requests for20102011201220132014Financial aid6411686101143Service311112733Equipment1311111823Transport312357Medications51534449114Patient cost of medications for which aid requested$731,891$1,554,684$1,253,827FDA approvals for new Oncology medications61181513 Disclosures No relevant conflicts of interest to declare.

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

European Journal of Public Health ◽

10.1093/eurpub/ckz186.379 ◽

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.

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Cancer patients’ perception of usefulness with wearable exercise tracker.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.34_suppl.51 ◽

2018 ◽

Vol 36 (34_suppl) ◽

pp. 51-51

Author(s):

Amy Ng ◽

Ekta Gupta ◽

Swati Bansal ◽

Rhodora C. Fontillas ◽

Janet L. Williams ◽

...

Keyword(s):

Heart Rate ◽

Cancer Patients ◽

College Education ◽

Well Being ◽

Outpatient Rehabilitation ◽

P Value ◽

Resting Heart Rate ◽

Or Education ◽

Patient Reported ◽

Steps Per Day

51 Background: Wearable trackers (WT) are known for its popular use in healthy, active persons but limited studies have been conducted in cancer survivors. Methods: Participants were asked to wear the WT and synchronize data. Patients were asked to fill out questionnaire regarding their patient reported perceptions of the WT and their perception of usefulness of the WT. Results: 110 cancer patients were enrolled with 100 evaluable surveys. Median age of patients was 62 years old, females (60, 55%), white (79,73%), married/with significant other (77, 71%), with college education and above (51, 47%). There was no statistically significant association between demographic factors of age, gender, ethnicity, marital status, or education and the perception of usefulness of the WT. Eighty-four percent of outpatient (OP) and 67% of inpatient (IP) cancer patients perceived WT as useful, 96% OP and 94% IP reported wearing WT daily, 64% OP and 55% IP perceived WT as helping to increase physical activity and 76% OP and 59% IP would continue to wear WT after this study. For inpatients, ESAS score of pain (p value <0.001), shortness of breath (p value <0.0002) and feeling of well-being (p value <0.001) improved over the course of rehabilitation. Improvement in FIM scores for transfers to wheelchair, walk assistance, walk distance, walking, stairs assistance, and stairs is significantly improved in rehabilitation (p value<0.05). The average resting heart rate was 77 beats per minute and average number of steps per day was 1,863. For outpatients, the average resting heart rate was 77 beats per minute and average number of steps per day was 3,423. Patients who reported the WT as useful had significantly lower fatigue severity (3.3 vs. 6, p value<0.05). Conclusions: Cancer patients perceived the WT as useful in both the inpatient and outpatient rehabilitation setting. No specific sub-group(s) of patients who expressed a higher level of agreement for usefulness of a wearable exercise tracker. There was an association between lower ESAS fatigue score and patient agreement of usefulness of the WT. These findings justify more research in WT and cancer rehabilitation. Clinical trial information: NCT03042884.

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