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- Title
Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy.
- Authors
Harris, Jeremy P.; Ku, Eric; Harada, Garrett; Hsu, Sophie; Chiao, Elaine; Rao, Pranathi; Healy, Erin; Nagasaka, Misako; Humphreys, Jessica; Hoyt, Michael A.
- Abstract
Introduction: Financial toxicity has negative implications for patient well-being and health outcomes. There is a gap in understanding financial toxicity for patients undergoing palliative radiotherapy (RT). Methods: A review of patients treated with palliative RT was conducted from January 2021 to December 2022. The FACIT-COST (COST) was measured (higher scores implying better financial well-being). Financial toxicity was graded according to previously suggested cutoffs: Grade 0 (score ≥26), Grade 1 (14-25), Grade 2 (1-13), and Grade 3 (0). FACIT-TS-G was used for treatment satisfaction, and EORTC QLQ-C30 was assessed for global health status and functional scales. Results: 53 patients were identified. Median COST was 25 (range 0-44), 49% had Grade 0 financial toxicity, 32% Grade 1, 15% Grade 2, and 4% Grade 3. Overall, cancer caused financial hardship among 45%. Higher COST was weakly associated with higher global health status/Quality of Life (QoL), physical functioning, role functioning, and cognitive functioning; moderately associated with higher social functioning; and strongly associated with improved emotional functioning. Higher income or Medicare or private coverage (rather than Medicaid) was associated with less financial toxicity, whereas an underrepresented minority background or a non-English language preference was associated with greater financial toxicity. A multivariate model found that higher area income (HR.80, P =.007) and higher cognitive functioning (HR.96, P =.01) were significantly associated with financial toxicity. Conclusions: Financial toxicity was seen in approximately half of patients receiving palliative RT. The highest risk groups were those with lower income and lower cognitive functioning. This study supports the measurement of financial toxicity by clinicians.
- Subjects
LANGUAGE &; languages; CANCER treatment; PALLIATIVE treatment; HEALTH status indicators; INCOME; INSURANCE; DATA analysis; HEALTH; FUNCTIONAL assessment; MEDICARE; KRUSKAL-Wallis Test; LOGISTIC regression analysis; QUESTIONNAIRES; EVALUATION of medical care; EMOTIONS; RETROSPECTIVE studies; MULTIVARIATE analysis; FINANCIAL stress; CHRONIC diseases; WORLD health; SURVEYS; KAPLAN-Meier estimator; QUALITY of life; SOCIAL skills; ELECTRONIC health records; STATISTICS; TUMORS; PATIENT satisfaction; MINORITIES; RADIATION doses; COGNITION; SPECIALTY hospitals; REGRESSION analysis; PROPORTIONAL hazards models; OVERALL survival; PATIENT aftercare
- Publication
American Journal of Hospice & Palliative Medicine, 2024, Vol 41, Issue 6, p592
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/10499091231187999