Defining the clinician's role in mitigating financial toxicity: an exploratory study.
Defining the clinician's role in mitigating financial toxicity: an exploratory study.
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DOI：
10.1007/s00520-021-05984-6
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Patel M
中科院分区：
文献类型：
--
作者：
Ragavan M;Parikh D;Patel M
经济毒性描述了癌症诊断给患者带来的经济负担，并且越来越受到关注。尽管患者希望他们这样做，但许多临床医生目前并没有解决经济毒性问题。目前的文献探讨了医生的观点，但没有明确定义一个可行的作用，临床医生可以采取解决财务毒性。我们试图通过首先评估临床医生对他们在减轻我们机构财务毒性方面的作用的看法来填补这一空白。随后，我们的目标是确定目前的障碍，以减轻金融毒性，并收集反馈意见，以临床医生为导向的干预措施，以解决这一日益严重的问题。我们通过Redcap开发了一个18项电子匿名调查。我们邀请了所有肿瘤临床医生，包括主治医生，高级实践提供者和我们机构的学员参加。共有72名临床医生（30%）完成了调查。大多数人同意，临床医生在解决成本方面发挥作用。与患者讨论费用的前三大障碍是自付费用的知识、时间和资源意识。不到一半的受访者使用现有的比较成本工具，将成本意识纳入治疗决策。最需要的干预措施是机构资源指南。在开放式评论中，所描述的最常见的障碍是自付费用的透明度，所提出的最常见的解决方案是采用多学科方法来解决患者面临的财务问题。提高价格透明度，将现有资源纳入临床实践，以及简化多学科支持可能有助于克服解决财务毒性的障碍。
Financial toxicity describes the financial burden imposed onto patients by a cancer diagnosis and is a growing concern. Many clinicians do not currently address financial toxicity despite patients’ desire for them to do so. Current literature explores physicians’ perspectives but does not clearly define an actionable role clinicians can take to address financial toxicity. We sought to fill this gap by first assessing clinicians’ perspective on their role in alleviating financial toxicity at our institution. We subsequently aimed to identify current barriers to mitigating financial toxicity and to garner feedback on clinician-oriented interventions to address this growing problem. We developed an 18-item electronic, anonymous survey through Redcap. We invited all oncology clinicians including attending physicians, advance practice providers, and trainees at our institution to participate. A total of 72 clinicians (30%) completed the survey. The majority agreed that clinicians have a role in addressing cost. The top three barriers to discussing cost with patients were knowledge of out of pocket costs, time, and awareness of resources. Less than half of respondents used an existing comparative cost tool to incorporate cost consciousness into treatment decisions. The most desired intervention was an institutional resource guide. In open-ended comments, the most common barrier described was transparency of out of pocket costs, and the most common solution proposed was a multi-disciplinary approach to addressing financial concerns patient face. Improving price transparency, incorporating existing resources into clinical practice, and streamlining multi-disciplinary support may help overcome barriers to addressing financial toxicity.
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