Financial Distress and its Predicting Factors among Iranian Cancer Patients

Abstract Objective This study aims to evaluate the psychometric properties of the Persian version of financial toxicity (COST) scale in a sample of cancer patients in Iran. Methods A total of 398 cancer patients completed a demographic questionnaire and the 11-item Persian COST. Performing a Maximum likelihood exploratory factor analysis, extracted three factors of financial worry (four items), financial distress (three items) and direct and indirect cost of control (three items) accounting for 65.204% of the variance. The highest load was related to financial distress and the lowest was related to direct and indirect costs concerns. Results The results of conducting confirmatory factor analysis indicated that the three-factor measurement model had a good fit. Moreover, the measurement model showed good items consistency, good construct reliability, as well as good construct validity in terms of convergent and discriminant validity. Conclusion This study highlights the importance of validating the scale in different contexts as the structure and loadings of the factors have appeared diffidently in various countries. The validated Persian COST can be used in future studies in Iran as a reliable and valid scale to measure financial toxicity among cancer patients.

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Breast Cancer: Reimbursement Policies and Adoption of New Therapeutic Agents by National Health Systems

Breast Care ◽

10.1159/000502637 ◽

2019 ◽

Vol 14 (6) ◽

pp. 373-381 ◽

Cited By ~ 1

Author(s):

Dario Trapani ◽

Giuseppe Curigliano ◽

Alexandru Eniu

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Priority Setting ◽

Financial Distress ◽

Quality Care ◽

Premature Death ◽

Health Coverage ◽

Breast Cancer Patients ◽

Middle Income ◽

Timely Access

Background: Breast cancer is a cause of morbidity for more than half a million of patients in Europe, resulting in broad societal impacts that affect patients, families, and societies from a human, emotional, economic, and financial perspective. Expenditure for cancer medicines represents one of the principal driving costs of healthcare. The aim of this review is to describe the European policy and regulatory landscape of innovation uptake in breast oncology – with emphasis on value in cancer healthcare. Summary: In Europe, several reimbursement models or policy tools have been developed by countries to compose their benefit packages. The most commonly applied scheme is the product-specific eligibility model, prioritizing selected medicines and their indications. Mixed models are commonly developed, addressing the protection of more vulnerable people, ensuring protection from impoverishment caused by cancer and containing disparities. However, the risk to incur significant out-of-pocket expenses for essential or newer medicines for cancer is still substantial in Europe, especially in low- and middle-income countries, determining greater financial distress and poorer outcome for patients. Value-based priority setting is an essential mechanism to ensure timely access to the most valuable medicines for breast cancer patients. Estimations of the value of medicines can be provided within health technology assessment services and networks and informed by benefit scales and tools. Key Messages: There is ample room for reciprocal support across the diverse cultural and legal realities in Europe. The aim is common: save cancer patients from premature death by ensuring the timely access to the best care, protecting from financial hardships and distress to leave no cancer patient behind in poverty. Steps are to be taken to promote value-based priority setting, paving the way toward universal health coverage in Europe, where health of people is protected, and affordable best quality care is the only standard pursued and acceptable.

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Response predicting factors to recombinant human erythropoietin in cancer patients undergoing platinum-based chemotherapy

Cancer ◽

10.1002/cncr.10980 ◽

2002 ◽

Vol 95 (11) ◽

pp. 2408-2413 ◽

Cited By ~ 9

Author(s):

Manolo González-Barón ◽

Amdio Ordóñez ◽

Rosa Franquesa ◽

Manuel Constenla ◽

Joaquin Montalar ◽

...

Keyword(s):

Cancer Patients ◽

Recombinant Human Erythropoietin ◽

Human Erythropoietin ◽

Predicting Factors ◽

Platinum Based Chemotherapy

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Predicting Factors of Nonsentinel Lymph Node Metastasis in Breast Cancer Patients with Sentinel Lymph Node Metastasis

Journal of the Korean Surgical Society ◽

10.4174/jkss.2010.79.1.20 ◽

2010 ◽

Vol 79 (1) ◽

pp. 20 ◽

Cited By ~ 1

Author(s):

Jae Young Park ◽

Keun Myoung Park ◽

Jeong Mi Park ◽

Kang Yeun Lee ◽

Youn Hee Moon ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Sentinel Lymph Node Metastasis ◽

Breast Cancer Patients ◽

Node Metastasis ◽

Predicting Factors ◽

Nonsentinel Lymph Node

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Frequency and factors predicting the risk for aberrant opioid use in patients receiving outpatient palliative care at a comprehensive cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.31_suppl.228 ◽

2017 ◽

Vol 35 (31_suppl) ◽

pp. 228-228

Author(s):

Sriram Yennu ◽

Tonya Edwards ◽

Joseph Anthony Arthur ◽

Zhanni Lu ◽

John M Najera ◽

...

Keyword(s):

At Risk ◽

Multivariate Analysis ◽

Drug Use ◽

Supportive Care ◽

Cancer Patients ◽

Financial Distress ◽

Male Gender ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Edmonton Symptom Assessment Scale

228 Background: Opioid misuse is a growing crisis among patients with chronic pain. Cancer patients at risk of aberrant drug behaviors (ADB) are frequently underdiagnosed in routine cancer care. The aim of this study was to determine the frequency and factors predicting risk for Aberrant Opioid and Drug use among Patients receiving Outpatient Supportive Care Consultation at a Comprehensive Cancer Center Methods: In this retrospective study, 690 consecutive patients referred to a supportive care clinic were reviewed. Patients were eligible if they were ≥18 years, had a diagnosis of cancer, and were on opioids for pain for atleast a week. All patients were assessed with the Edmonton Symptom Assessment Scale (ESAS), SOAPP-14, and CAGE-AID. At risk patients with aberrant opioid behavior (+Risk) was defined as SOAPP-14 score ≥7. Descriptive statistics, spearman correlation coefficient, multivariate analysis were performed. Results: 690/752 consults were eligible. A total of 135(20%)were +risk. 69(11%) were CAGE-AID +.SOAPP-14 scores were positively associated with CAGE-AID p < 0.001; male gender p = 0.007; ESAS pain p = < 0.006; ESAS depression p < 0.001; ESAS anxiety, p < 0.001, and ESAS financial distress p = < 0.001. Multivariate analysis indicated that the odds ratio for +Risk was 2.47 in patients with CAGE-AID+ (p < 0.001), 1.95 for male gender (p = 0.005), 1.11 per point for ESAS anxiety (p = 0.019), and 1.1 per point. for ESAS financial distress (p = 0.02). Conclusions: 20% of cancer patients on opioids presenting to supportive care center are at risk of aberrant drug behavior. Male patients with anxiety, financial distress, and prior alcoholism/illicit drug use are significant predictors of +Risk. Further research to effectively manage these patients is needed.

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Clinical and demographic variables of young adult (YA) patients referred to inpatient supportive care.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.34_suppl.168 ◽

2018 ◽

Vol 36 (34_suppl) ◽

pp. 168-168

Author(s):

Sujin Ann-Yi ◽

Angelique Wong ◽

Jimin Wu ◽

Maira Charone ◽

Karen Baumgartner ◽

...

Keyword(s):

Young Children ◽

Supportive Care ◽

Cancer Patients ◽

Financial Distress ◽

Eastern Cooperative Oncology Group ◽

Age Groups ◽

Social Needs ◽

Aged Patients ◽

Age Cohorts ◽

Pain Expression

168 Background: Literature suggests that YA cancer patients have unique psychosocial issues and more emotional distress compared to older aged patients. Our study aimed to evaluate clinical and demographic factors of YA cancer patients that may impact physical and psychosocial symptom expression. Methods: A retrospective review was conducted on randomly selected patients seen during 2013-2015 of 3 age groups: 18-39 (YA), 40-64, and 65 and older on demographic, medical, psychosocial history, Morphine Equivalent Daily Dose (MEDD), Edmonton Symptom Assessment Scare (ESAS) scores, and Eastern Cooperative Oncology Group (ECOG) scores which are completed at time of initial consultation with the supportive care inpatient mobile team. Results: 896 (YA = 297, 40-64 cohort = 300, 65 and older = 299) patients were reviewed. YA cohort was associated with being female (n = 179 (60%), p = 0.03), more frequently non-white (Black and Hispanic = 124 (42%), p < 0.00), higher ECOG scores (ECOG 0-2 = 83(39%), p < 0.00) more psychiatric history (n = 95(32%), p = 0.00) and worse ESAS sleep scores (median = 6, p = 0.02). The YA cohort also had higher pain expression than the 65 and older cohort (p = .02). The YA group was more likely to have children younger than 18 years old (n = 171(58%), p < 0.00). Patients with children less than 18 years of age reported higher pain expression (median = 6, p = .05), sleep (median = 6, p = 0.01), and financial distress (median = 2, p = 0.02). Conclusions: Contrary to other findings, YA cancer patients did not report higher symptoms or distress when compared to older age cohorts, with the exception of higher insomnia compared to other age cohorts and higher pain expression than the oldest age cohort. YA with young children reported higher level of pain, sleep and financial distress. Our findings suggest that the YA population may benefit from specialized psychosocial services to address their unique social needs, particularly to address concerns related to being parents of young children.

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