Physician-patient communication of costs and financial burden of cancer and its treatment: a systematic review of clinical guidelines.
Physician-patient communication of costs and financial burden of cancer and its treatment: a systematic review of clinical guidelines.
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DOI：
10.1186/s12885-021-08697-5
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发表时间：
2021-09-16
期刊：
影响因子：
3.8
通讯作者：
Morton RL
中科院分区：
文献类型：
--
作者：
Agarwal A;Livingstone A;Karikios DJ;Stockler MR;Beale PJ;Morton RL
优化癌症患者的护理而不给他们的抗癌治疗带来重大的经济负担正变得越来越困难。美国临床肿瘤学会（ASCO）建议临床医生与患者讨论癌症治疗的费用，以加强共同决策。我们寻找信息来指导肿瘤学家与患者讨论这些费用。我们检索了2009年1月至2019年6月1日的Medline、EMBASE和临床实践指南数据库，以获取有关讨论护理成本和经济负担的建议。使用AGREE-II工具评估指南质量。27份指南符合我们的入选标准，其中16份来自ASCO（59%）。27份指南中有21份（78%）建议在开处方时讨论或考虑治疗费用，4份（15%）提供了有关实际费用的信息。81%（22/27）的指南描述了对财务负担或财务毒性风险的认识。然而，只有9份指南（33%）包含了管理财务负担的信息。目前的临床实践指南几乎没有信息来指导医患讨论抗癌治疗的费用和经济负担的管理。这限制了患者控制治疗费用的能力，并为医疗团队减少了发病率和严重的经济负担。目前的指南建议临床医生认识到价格的可变性和治疗的高成本。建议临床医生探索成本问题并解决财务问题，特别是在高风险人群中。未来的准则应包括关于促进成本透明度讨论的建议，并提供成本资料和资源。在线版本包含补充材料，可在10.1186/s12885-021-08697-5获得。
Optimising the care of individuals with cancer without imposing significant financial burden related to their anticancer treatment is becoming increasingly difficult. The American Society of Clinical Oncology (ASCO) has recommended clinicians discuss costs of cancer care with patients to enhance shared decision-making. We sought information to guide oncologists’ discussions with patients about these costs. We searched Medline, EMBASE and clinical practice guideline databases from January 2009 to 1 June 2019 for recommendations about discussing the costs of care and financial burden. Guideline quality was assessed with the AGREE-II instrument. Twenty-seven guidelines met our eligibility criteria, including 16 from ASCO (59%). 21 of 27 (78%) guidelines included recommendations about discussion or consideration of treatment costs when prescribing, with information about actual costs in four (15%). Recognition of the risk of financial burden or financial toxicity was described in 81% (22/27) of guidelines. However, only nine guidelines (33%) included information about managing the financial burden. Current clinical practice guidelines have little information to guide physician-patient discussions about costs of anticancer treatment and management of financial burden. This limits patients’ ability to control costs of treatment, and for the healthcare team to reduce the incidence and severity of financial burden. Current guidelines recommend clinician awareness of price variability and high costs of treatment. Clinicians are recommended to explore cost concerns and address financial worries, especially in high risk groups. Future guidelines should include advice on facilitating cost transparency discussions, with provision of cost information and resources. The online version contains supplementary material available at 10.1186/s12885-021-08697-5.
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影响因子：
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作者：
Bullock, Andrea J.;Hofstatter, Erin W.;Buss, Mary K.
通讯作者：
Buss, Mary K.
影响因子：
45.3
作者：
Meropol, Neal J.;Schrag, Deborah;Schnipper, Lowell E.
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影响因子：
45.3
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Rowland, Julia H.
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Hwang, E. Shelley
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作者：
Graham, Ian D;Harrison, Margaret B
通讯作者：
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