A new tool could help predict the patient's risk for toxicity financial -
cancer care has a new side effect. Alongside the distress that comes with a cancer diagnosis and the discomforts of treatment, more patients are now facing "financial toxicity," the expense, anxiety and loss of confidence to those who face significant, unpredictable costs, often compounded by a decreased ability to work
in the July number of cancer , a team from the University of Chicago cancer specialists described the first tool -. 11 questions, assembled and refined from conversations with more than 150 patients with advanced stage cancer. - to measure the risk of a patient, and the ability to tolerate, financial stress researchers have named their patient reported COST measurement results (Score Comprehensive financial toxicity).
"Few doctors discuss this side effect more and more important with their patients," said study author Jonas de Souza, MD , HEADBANDS and neck cancer specialist at the University of Chicago Medicine. "Doctors are not trained to do. They, as well as patients actually uncomfortable, "he said. "We are not good. We believe that a thoughtful concise tool that could help predict the risk of a patient for the financial toxicity could open the lines of communication. This gives us a way to start this discussion."
The timing is right. The cost of health care in the US is increasing faster than gross domestic product. The cost of cancer care is rising faster than the cost of health care, and the cost of new drugs against cancer is rising faster than the cost of comprehensive treatment of cancer.
financial pain may extend beyond the treatment. A recent study from the Centers for Disease Control and Prevention found that 30 percent of cancer survivors are able to return to work, or impaired ability to work. annual medical expenditures increase of more than $ 4,000 for men who have had cancer and nearly $ 3,300 for women.
"We need better ways to find out which patients are most at risk," de Souza said. "Then we can help them obtain financial assistance. If patients know what to expect, they may want their doctors to consider less expensive drugs."
COST Questionnaire Development began with a literature review and a series of extensive interviews. de Souza and colleagues talked with 20 patients and six occupational cancer, as well as nurses and social workers. This produced a list of 147 questions. The researchers trimmed the list to 58 questions. Then they asked 35 patients to help them decide which of the remaining issues were the most important. Patients narrowed the list to 30.
"In the end, 155 patients led us, with a little judicious editing, a set of 11 statements," said Souza. "It was short enough to prevent embarrassing those who have answered the questions, but deep enough to get us the information we need."
The 11 entries are short and easy to understand. For example, Article 2 states: My out-of-pocket medical expenses are more than I thought they would be. Point 7, more optimistic, says: I am able to meet my monthly expenses. For each question, patients choose from five possible answers: not at all, somewhat, a little, some or a lot
Learn how a patient responds can help caregivers determine who is likely to need of Education. , Financial advice or referral to a support network. The quiz can also predict who is likely to have problems and require intervention.
All patients that helped develop the study had been in treatment for at least two months and had received bills. Excluding the 10 percent and 10 percent, the patients in the study earned between $ 37,000 and $ 111,000. The median annual income for these patients was approximately $ 63,000.
The researchers expected that the financial toxicity is correlated with income. "But in our small sample that does not hold water," de Souza said. "People with less education seemed to have more financial distress, but changes in income does not make much difference. We need more larger studies to confirm this, but at least we now have a tool that we can use to study this. "
researchers are now conducting a larger study to validate these results and correlate across newly developed with the quality of life and anxiety in cancer patients.
"We need to evaluate the results that are important to patients," de Souza said. The cost burden of cancer patients experience is certainly one. The extent of this toxicity is the first step towards the resolution of this important issue. "In the end," he added, "This is another important piece of information in the shared decision making process."
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