Health Outcomes and Biomedical Informatics

Point-of-care Intervention to Address Financial Toxicity in Patients with Cancer

Faculty Mentor’s Name: Dr. Ramzi Salloum
Phone Number: (352) 294-4997
Project Category: Clinical
International Component or Travel: No

Research Project Description:
Treatment advances in cancer care have come with increases in treatment costs that have impacted cancer patients, leading to financial toxicity. Financial toxicity refers to the mental, physical, and emotional stress that is caused by the costs of cancer treatments, and has been shown to result in reduced quality of life, reduced treatment adherence, and poor survival outcomes. Notably, a clear divide exists between urban and rural populations with respect to the burden of financial toxicity due to cancer. The CDC reports that compared to urban survivors, rural cancer survivors were more likely to forgo medical care due to cost. Rural patients also face additional barriers, such as a lack of or limited nearby health delivery services, and transportation time and cost to access treatment facilities. Given these factors, rural cancer patients are at an increased risk of financial toxicity compared to urban patients. Despite these disparities, there is a paucity of research on interventions that address cancer-induced financial toxicity in rural populations. Identifying patients who experience financial toxicity and testing interventions to connect them with financial counseling services is a promising strategy. As most recent experiences have revealed, telehealth has become a critical link to support cancer patients in the context of situations that may prevent them from in-person visits such as stay-at-home orders experienced nationwide in response to the COVID-19 pandemic. Telehealth platforms may be especially effective for rural cancer patients who experience additional challenges in accessing healthcare services. Our specific aims are to: (1) Assess the feasibility, acceptability, and usability of a group and individual telehealth platform format to deliver financial counseling to cancer patients with financial toxicity; (2) Evaluate the preliminary efficacy of financial counseling in reducing financial toxicity and improving cancer treatment adherence in a randomized control trial; and (3) Explore the feasibility of using the EHR to automatically identify patients with financial toxicity.
Medical students will work on all aspects of the study by assisting in facilitating implementation in clinical settings, assisting with focus groups and training activities, contributing to qualitative and quantitative analysis of study results, and dissemination of study findings at scientific meetings and in peer-reviewed publications.

Hong YR, Salloum RG, Yadav S, Smith G, Mainous AG. Patient-provider discussion about cancer treatment costs and out-of-pocket spending: Implications for shared decision-making in cancer care. Value in Health, 2020.