A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer
ABSTRACT Background Financial toxicity (FT) is a common and significant challenge for people with cancer, impacting immediate clinical outcomes such as treatment adherence, as well as long‐term outcomes such as quality of life and mortality. Multiple studies have tested interventions to address FT a...
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Wiley
2025-04-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70879 |
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| author | Christina Ping D. Carolina Andrade Ashley Housten Michelle Doering Eliana Goldstein Mary C. Politi |
| author_facet | Christina Ping D. Carolina Andrade Ashley Housten Michelle Doering Eliana Goldstein Mary C. Politi |
| author_sort | Christina Ping |
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| description | ABSTRACT Background Financial toxicity (FT) is a common and significant challenge for people with cancer, impacting immediate clinical outcomes such as treatment adherence, as well as long‐term outcomes such as quality of life and mortality. Multiple studies have tested interventions to address FT and develop recommendations for their implementation. Methods In this scoping review, we analyzed thirty‐six studies across 35,405 participants examining institution‐based interventions for FT in both pediatric and adult patients and survivors of cancer in the U.S. Results Common interventions included: financial navigation (n = 15), direct financial/medical assistance (n = 8), financial counseling or coaching (n = 5), and cost conversations prompters or encounter decision aids for treatment and cost (n = 5). Outcome measures varied widely, including the COmprehensive Score for financial Toxicity (COST), the Medical Expenditure Panel Survey (MEPS), total out‐of‐pocket costs or savings, and mental/psychological quality‐of‐life measured by the Patient‐Reported Outcomes Measurement Information System (PROMIS). Many interventions showed promising results on improving FT, including financial assistance (e.g., free medication, copay assistance), treatment and insurance decision aids, and financial counseling. These strategies improved FT‐related metrics, including patient out‐of‐pocket costs, care‐related financial burden, health insurance knowledge, quality of life, and even overall survival. There was no dominant intervention method, with both low‐ and high‐resource options proving effective. Discussion Future research should seek to understand causal relationships between interventions and FT through robust study designs, such as randomized controlled trials with longitudinal follow‐up, and evaluate interventions' implementation potential. There is also a need for standardized metrics for evaluating and reporting FT to better compare different interventions' success. |
| format | Article |
| id | doaj-art-e75f2c6c6a5e4fd1bdde5abc67e984fd |
| institution | OA Journals |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-e75f2c6c6a5e4fd1bdde5abc67e984fd2025-08-20T02:24:54ZengWileyCancer Medicine2045-76342025-04-01148n/an/a10.1002/cam4.70879A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of CancerChristina Ping0D. Carolina Andrade1Ashley Housten2Michelle Doering3Eliana Goldstein4Mary C. Politi5Washington University School of Medicine Saint Louis Missouri USADepartment of Surgery, Division of Public Health Sciences Washington University School of Medicine Saint Louis Missouri USADepartment of Surgery, Division of Public Health Sciences Washington University School of Medicine Saint Louis Missouri USABernard Becker Medical Library Washington University School of Medicine Saint Louis Missouri USASchool of Public Health Washington University in St. Louis Saint Louis Missouri USASchool of Public Health Washington University in St. Louis Saint Louis Missouri USAABSTRACT Background Financial toxicity (FT) is a common and significant challenge for people with cancer, impacting immediate clinical outcomes such as treatment adherence, as well as long‐term outcomes such as quality of life and mortality. Multiple studies have tested interventions to address FT and develop recommendations for their implementation. Methods In this scoping review, we analyzed thirty‐six studies across 35,405 participants examining institution‐based interventions for FT in both pediatric and adult patients and survivors of cancer in the U.S. Results Common interventions included: financial navigation (n = 15), direct financial/medical assistance (n = 8), financial counseling or coaching (n = 5), and cost conversations prompters or encounter decision aids for treatment and cost (n = 5). Outcome measures varied widely, including the COmprehensive Score for financial Toxicity (COST), the Medical Expenditure Panel Survey (MEPS), total out‐of‐pocket costs or savings, and mental/psychological quality‐of‐life measured by the Patient‐Reported Outcomes Measurement Information System (PROMIS). Many interventions showed promising results on improving FT, including financial assistance (e.g., free medication, copay assistance), treatment and insurance decision aids, and financial counseling. These strategies improved FT‐related metrics, including patient out‐of‐pocket costs, care‐related financial burden, health insurance knowledge, quality of life, and even overall survival. There was no dominant intervention method, with both low‐ and high‐resource options proving effective. Discussion Future research should seek to understand causal relationships between interventions and FT through robust study designs, such as randomized controlled trials with longitudinal follow‐up, and evaluate interventions' implementation potential. There is also a need for standardized metrics for evaluating and reporting FT to better compare different interventions' success.https://doi.org/10.1002/cam4.70879financial stresshealth expenditureneoplasmquality of life |
| spellingShingle | Christina Ping D. Carolina Andrade Ashley Housten Michelle Doering Eliana Goldstein Mary C. Politi A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer Cancer Medicine financial stress health expenditure neoplasm quality of life |
| title | A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer |
| title_full | A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer |
| title_fullStr | A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer |
| title_full_unstemmed | A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer |
| title_short | A Scoping Review of Interventions to Address Financial Toxicity in Pediatric and Adult Patients and Survivors of Cancer |
| title_sort | scoping review of interventions to address financial toxicity in pediatric and adult patients and survivors of cancer |
| topic | financial stress health expenditure neoplasm quality of life |
| url | https://doi.org/10.1002/cam4.70879 |
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