Advanced Cancer, Metastatic Cancer
Conditions
Keywords
Financial Toxicity
Brief summary
The study aims to determine whether monthly remote digital financial hardship screening among adults with advanced/metastatic cancer, undergoing outpatient systemic therapy with non-curative intent, improves patient-centered outcomes, including financial worry, health-related quality of life (HRQoL), symptom burden, patient-reported cancer treatment adherence, and exploratory outcomes of overall survival, patient-reported economic burden, patient-reported support received, patient-reported financial coping strategies, and health insurance literacy.
Detailed description
Financial hardship is a common problem that affects patients treated for advanced cancer and leads to poor outcomes related to financial worry, health related quality of life (HRQoL), symptom burden, treatment adherence, and overall survival. Prior studies have shown that financial navigation may be an effective strategy to attenuate the impact of financial hardship. However, patients and clinicians have identified communication as a key barrier that prevents patients from being connected to sources of financial assistance. To address this critical gap in patient care, and based on strong preliminary data that financial hardship screening may improve patient outcomes, this financial hardship screening intervention will help connect patients to financial navigation resources. It is hypothesized that by connecting patients experiencing financial hardship with financial navigation resources, this intervention will lead to improved patient-centered outcomes.
Interventions
OTHERFinancial Hardship Screening
Financial Hardship Screening and Financial Needs Assessment
OTHEREnhanced Usual Care
Enhanced Usual Care
Sponsors
Alliance Foundation Trials, LLC.
Memorial Sloan Kettering Cancer Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Minimum age of 21 2. Understands English and/or Spanish 3. Has a diagnosis of advanced/metastatic cancer 4. Currently undergoing systemic therapy (enteral or parenteral) with non-curative intent 5. Has been receiving treatment for at least 2 months 6. Life expectancy of at least 6 months, in the opinion of the treating oncologist 7. Cognitively able to give informed consent
Exclusion criteria
1. Under the age of 21 2. Does not understand English or Spanish 3. Has cognitive deficits that would preclude understanding of consent form and/or questionnaires 4. Undergoing treatment with curative intent (e.g., adjuvant chemotherapy for breast, lung, or ovarian cancer, primary curative therapy for testis cancer or lymphoma) 5. Not undergoing systemic therapy (enteral or parenteral) with non-curative intent 6. Receiving treatment for fewer than 2 months 7. Life expectancy is less than 6 months, in the opinion of the treating oncologist
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Financial Worry | 6 months | Patient-reported financial worry will be measured by the Functional Assessment of Chronic Illness Therapy-Comprehensive Score for Financial Toxicity (FACIT-COST) total scale. Possible score range: 0 to 44, with higher scores indicating better outcomes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Health-related quality of life | 6 months | Patient-reported health-related quality of life will be measured by the Functional Assessment of Cancer Therapy-General (FACT-G) total scale. Possible score range: 0 to 108, with higher scores indicating better outcomes |
| Symptom burden | 6 months | Patient-reported symptom burden will be measured by the Functional Assessment of Cancer Therapy-General (FACT-G) physical well-being scale. Possible score range: 0 to 28, with higher scores indicating better outcomes |
| Cancer treatment adherence | 6 months | Patient-reported cancer treatment adherence will be measured by the Domains of Subjective Extent of Nonadherence-Cancer (DOSE-Nonadherence-Cancer) extent of nonadherence scale, with patients classified as adherent (i.e., all responses of "none of the time" on the DOSE-Nonadherence-Cancer items for missing, skipping, or not taking a dose of medicine) versus nonadherent |
Countries
Puerto Rico, United States
Contacts
CONTACTAFT Quality Management Group Inbox
PRINCIPAL_INVESTIGATORVictoria Blinder, MD, MSc
Memorial Sloan Kettering Cancer Center
Outcome results
None listed