Patient-Provider Communication and Cancer-Related Financial Hardship in the Context of Serious Illness (Sch449)

• Published in: Journal of pain and symptom management 2023-05, Vol.65 (5), p.e605-e606
• Main Authors: Green, Chelsea A., Yeager, Katherine, Curseen, Kimberly A., Thomas, Teresa H., Schenker, Yael, Belcher, Sarah M.
• Format: Article
• Language: English
• ISSN: 0885-3924
• DOI: 10.1016/j.jpainsymman.2023.02.186

1. Describe perceived patient-provider communication about out-of-pocket cancer care costs among diverse patients with advanced cancer receiving outpatient palliative care. 2. Examine variables and factors that may impact perceived financial hardship among diverse patients with advanced cancer receiving outpatient palliative care. Palliative care (PC) guidelines include assessment of and communication about financial hardship (FH), but these conversations inconsistently occur. The purpose of this study is to describe patients’ perceptions of provider communication about cancer costs and to explore the relationship between provider communication about cancer costs and perceived FH among diverse patients with advanced cancer receiving outpatient PC. Secondary analysis of a cross-sectional, multisite study of FH and quality of life among n=67 patients with advanced cancer receiving outpatient PC. We assessed perceived FH (COmprehensive Score for Financial Toxicity [COST; 0-44, lower=worse]); patient-provider communication about cancer costs since first cancer diagnosis (Medical Expenditure Panel Survey single item, some versus no discussion); and sociodemographic and clinical characteristics (self-report and medical records). We computed descriptive statistics and ran independent sample t-tests and Pearson product-moment correlations to explore associations. Participants’ average age was 56.6 years (SD=12.2). Median time since cancer diagnosis was 40 months (IQR, 10-59). Most were female (58.2%) and white (49.3%) or Black (47.8%). Most (71.4%) had some (n=37) or extreme (n=8) difficulty paying for basic needs. Most (73.1%) reported no discussion of out-of-pocket cancer costs with any provider since first cancer diagnosis. The median COST score of FH was 15 (IQR, 9-23). The difference in FH scores between those who reported some discussion (M=14.06, SD=9.78) versus no discussion (M=17.65, SD=9.77) about cost was not significant [t (65)=-1.336, p=.186]. Post-hoc explorations identified significant associations between younger age and worse FH (r=.520, n=67, p