ASPO Abstracts
A novel, web-based intervention to reduce cancer treatment-related financial distress: a randomized controlled pilot study
Category: Behavioral Science & Health Communication, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018
Abstract Body:
Purpose: Many patients on anti-cancer therapy experience treatment-related financial burden. Pathlight, an interactive web application, was designed to: 1) screen for financial distress; 2) educate on health-related financial topics; 3) coach via video-conference on communicating with providers about costs; and 4) navigate to financial assistance. The primary aim of this study was to assess usability of Pathlight and its impact on financial distress, willingness to discuss costs with doctors, and knowledge. Methods: Adults with cancer who reported moderate financial distress and were receiving treatment in solid tumor oncology clinics were randomized 1:1 to Pathlight or usual care (text and video resources from Cancer.net). Patients randomized to usual care were crossed over to Pathlight after efficacy testing for usability. We used the validated System Usability Scale (SUS) to assess usability (SUS score >68 is above average). We assessed financial distress with the validated 11-item COmprehensive Score for financial Toxicity (COST) measure (lower score correlates with less financial distress). We asked patients if Pathlight “improved my knowledge about financial aspects of cancer care and what can be done about it,” and if “using this website was helpful with my financial concerns” with responses measured using a 5-point Likert scale. We assessed desire to discuss costs with, “Will you talk to your doctor about costs?” Results: 30 patients enrolled. 26 had usability data available. The median SUS score was 70. 94% of patients agreed/strongly agreed that Pathlight improved knowledge of financial aspects of cancer. 71% agreed/strongly agreed that the tool was helpful with financial concerns. Patients using Pathlight experienced a greater absolute decrease in median COST scores (3.5 vs 2.0 decrease). Relative to controls, a higher proportion would consider a cost discussion with their oncologist (33% vs 20%). Discussion: Pathlight demonstrates high usability and preliminary effectiveness in decreasing financial distress. Interventions such as Pathlight may improve quality of life and outcomes by reducing financial toxicity.
Keywords: cancer, behavioral intervention, cost of care, health services