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26.07.2021 | Original Article

Exploring the role of general practitioners in addressing financial toxicity in cancer patients

verfasst von: Carla Thamm, Jennifer Fox, Nicolas H. Hart, Joel Rhee, Bogda Koczwara, Jon Emery, Kristi Milley, Rebecca L. Nund, Raymond J. Chan

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2022

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Abstract

Purpose

Financial toxicity (FT) describes financial distress or hardship as an outcome of cancer and its treatment. Minimising the impact of FT requires early assessment and intervention. General practice plays a significant role in the support of a person with cancer and may have an important role in the management of FT. The purpose of this study was to understand perspectives of general practitioners (GP) on addressing FT in the primary care setting, which may then help inform strategies to further support collaborative efforts to address FT.

Methods

A qualitative interpretive approach was utilised for this study. GPs were recruited through a GP conference and other professional networks using purposive, snowballing sampling techniques. Data collection continued until sufficient rich data had been obtained. Interviews were recorded and transcribed verbatim. The data were analysed using inductive analysis techniques.

Results

Twenty (n = 20) GPs participated in semi-structured in-depth telephone interviews. GPs identified that their role positions them well to provide some FT support, but there are limitations. Perceptions and philosophies about cancer management were drivers of referrals and financial conversations. Priorities for care of FT by GPs included improved cost information provision and accessible support.

Conclusion

GPs can play an important role in helping to address FT associated with cancer and its treatments if supported with the right information.

Carrera PM, Kantarjian HM, Blinder VS (2018) The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. CA Cancer J Clin 68(2):153–165. https://doi.org/10.3322/caac.21443CrossRefPubMedPubMedCentral

Desai A, Gyawali B (2020) Financial toxicity of cancer treatment: moving the discussion from acknowledgement of the problem to identifying solutions. EClinicalMedicine 20:100269. https://doi.org/10.1016/j.eclinm.2020.100269CrossRefPubMedPubMedCentral

Kayser K, Smith L, Washington A, Harris LM, Head B (2020) Living with the financial consequences of cancer: a life course perspective. J Psychosoc Oncol 1–18. https://doi.org/10.1080/07347332.2020.1814933

Lentz R, Benson AB 3rd, Kircher S (2019) Financial toxicity in cancer care: prevalence, causes, consequences, and reduction strategies. J Surg Oncol 120(1):85–92. https://doi.org/10.1002/jso.25374CrossRefPubMed

Pearce A, Tomalin B, Kaambwa B, Horevoorts N, Duijts S, Mols F, van de Poll-Franse L, Koczwara B (2019) Financial toxicity is more than costs of care: the relationship between employment and financial toxicity in long-term cancer survivors. J Cancer Surviv 13(1):10–20. https://doi.org/10.1007/s11764-018-0723-7CrossRefPubMed

Zhu Z, Xing W, Zhang X, Hu Y, So WKW (2020) Cancer survivors’ experiences with financial toxicity: a systematic review and meta-synthesis of qualitative studies. Psychooncology 29(6):945–959. https://doi.org/10.1002/pon.5361CrossRefPubMed

Coughlin SS, Dean LT (2019) Cancer survivorship care plans, financial toxicity, and financial planning alleviating financial distress among cancer survivors. Support Care Cancer 27(6):1969–1971. https://doi.org/10.1007/s00520-019-04703-6CrossRefPubMedPubMedCentral

Longo CJ, Fitch MI, Banfield L, Hanly P, Yabroff KR, Sharp L (2020) Financial toxicity associated with a cancer diagnosis in publicly funded healthcare countries: a systematic review. Support Care Cancer 28(10):4645–4665. https://doi.org/10.1007/s00520-020-05620-9CrossRefPubMed

Gordon LG, Merollini KMD, Lowe A, Chan RJ (2017) A systematic review of financial toxicity among cancer survivors: we can’t pay the co-pay. Patient 10(3):295–309. https://doi.org/10.1007/s40271-016-0204-xCrossRefPubMed

10.

Kale HP, Carroll NV (2016) Self-reported financial burden of cancer care and its effect on physical and mental health-related quality of life among US cancer survivors. Cancer 122(8):283–289. https://doi.org/10.1002/cncr.29808CrossRefPubMed

11.

Khera N, Chang YH, Hashmi S, Slack J, Beebe T, Roy V, Noel P, Fauble V, Sproat L, Tilburt J, Leis JF, Mikhael J (2014) Financial burden in recipients of allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 20(9):1375–1381. https://doi.org/10.1016/j.bbmt.2014.05.011CrossRefPubMed

12.

Sharp L, Timmons A (2016) Pre-diagnosis employment status and financial circumstances predict cancer-related financial stress and strain among breast and prostate cancer survivors. Supportive Care Cancer 24(2):699–709. https://doi.org/10.1007/s00520-015-2832-4CrossRef

13.

Catalano PJ, Ayanian JZ, Weeks JC, Kahn KL, Landrum MB, Zaslavsky AM, Lee J, Pendergast J, Harrington DP, Cancer Care Outcomes Research Surveillance C (2013) Representativeness of participants in the cancer care outcomes research and surveillance consortium relative to the surveillance, epidemiology, and end results program. Med Care 51(2):e9-15. https://doi.org/10.1097/MLR.0b013e318222a711CrossRefPubMedPubMedCentral

14.

Fenn KM, Evans SB, McCorkle R, DiGiovanna MP, Pusztai L, Sanft T, Hofstatter EW, Killelea BK, Knobf MT, Lannin DR, Abu-Khalaf M, Horowitz NR, Chagpar AB (2014) Impact of financial burden of cancer on survivors’ quality of life. J Oncol Pract 10(5):332–338. https://doi.org/10.1200/JOP.2013.001322CrossRefPubMed

15.

Koczwara B (2017) Unemployment after cancer - a hidden driver of financial toxicity. Cancer Forum 41(2):36–41

16.

Currow D, Aranda S (2016) Financial toxicity in clinical care today: a “menu without prices”1. Med J Aust 204(11):397–397. https://doi.org/10.5694/mja16.00182CrossRefPubMed

17.

Chan R, Gordon L, Zafar S, Miaskowski C (2018) Financial toxicity and symptom burden: what is the big deal? Support Care Cancer Inpress. https://doi.org/10.1007/s00520-018-4092-6CrossRef

18.

World Health Organisation (2008) The World Health Report 2008: primary health care (now more than ever). https://www.who.int/whr/2008/en/. Accessed 7th Oct 2020

19.

Rubin G, Berendsen A, Crawford SM, Dommett R, Earle C, Emery J, Fahey T, Grassi L, Grunfeld E, Gupta S, Hamilton W, Hiom S, Hunter D, Lyratzopoulos G, Macleod U, Mason R, Mitchell G, Neal RD, Peake M, Roland M, Seifert B, Sisler J, Sussman J, Taplin S, Vedsted P, Voruganti T, Walter F, Wardle J, Watson E, Weller D, Wender R, Whelan J, Whitlock J, Wilkinson C, de Wit N, Zimmermann C (2015) The expanding role of primary care in cancer control. Lancet Oncol 16(12):1231. https://doi.org/10.1016/S1470-2045(15)00205-3CrossRefPubMed

20.

Charmaz K (2014) Constructing grounded theory. SAGE, London

21.

Silverman D (2017) Doing qualitative research, 5 end. SAGE, London

22.

Mitchell GK, Burridge LH, Colquist SP, Love A (2012) General practitioners’ perceptions of their role in cancer care and factors which influence this role. Health Soc Care Community 20(6):607–616. https://doi.org/10.1111/j.1365-2524.2012.01075.xCrossRefPubMed

23.

Australian Medical Association (2020) Informed financial consent: a collaboration between doctors and patients. AMA

24.

Australian Institute of Health Welfare (2020) Health system overview. AIHW. https://www.aihw.gov.au/reports/australias-health/health-system-overview. Accessed 10 Feb 2021

25.

Thomas T, Hughes T, Mady L, Belcher SM (2019) Financial toxicity: a review of the literature and nursing opportunities. Clin J Oncol Nurs 23(5):5–13. https://doi.org/10.1188/19.CJON.S2.5-13CrossRefPubMed

26.

Fischer KA, Walling A, Wenger N, Glaspy J (2020) Cost health literacy as a physician skill-set: the relationship between oncologist reported knowledge and engagement with patients on financial toxicity. Support Care Cancer. https://doi.org/10.1007/s00520-020-05406-zCrossRefPubMed

27.

Zafar SY (2016) Financial toxicity of cancer care: it’s time to intervene. J Natl Cancer Inst 108(5):370. https://doi.org/10.1093/jnci/djv370CrossRef

28.

Gordon LG, Chan RJ (2017) Financial toxicity among patients with cancer-where to from here? Cancer Nurs 40(4):257–258. https://doi.org/10.1097/NCC.0000000000000510CrossRefPubMed

29.

Sherman D, Fessele KL (2019) Financial support models: a case for use of financial navigators in the oncology setting. Clin J Oncol Nurs 23(5):14–18. https://doi.org/10.1188/19.CJON.S2.14-18CrossRefPubMed

30.

Lisy K, Kent J, Piper A, Jefford M (2021) Facilitators and barriers to shared primary and specialist cancer care: a systematic review. Support Care Cancer 29(1):85–96. https://doi.org/10.1007/s00520-020-05624-5CrossRefPubMed

31.

Chan A, Ashbury F, Fitch MI, Koczwara B, Chan RJ (2020) Cancer survivorship care during COVID-19-perspectives and recommendations from the MASCC survivorship study group. Support Care Cancer 28(8):3485–3488. https://doi.org/10.1007/s00520-020-05544-4CrossRefPubMedPubMedCentral

32.

Cancer Australia (2020) COVID-19 recovery: implications for cancer care

Titel: Exploring the role of general practitioners in addressing financial toxicity in cancer patients
verfasst von: Carla Thamm
Jennifer Fox
Nicolas H. Hart
Joel Rhee
Bogda Koczwara
Jon Emery
Kristi Milley
Rebecca L. Nund
Raymond J. Chan
Publikationsdatum: 26.07.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 1/2022
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-021-06420-5

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Exploring the role of general practitioners in addressing financial toxicity in cancer patients