Study to assess remote screening for financial hardship in patients with cancer
The Patient-Centered Outcomes Research Institute awarded almost $10.5 million to Alliance NCTN Foundation to assess the value of remote digital screening for financial hardship to improve patient-centered outcomes in patients with cancer.
Victoria Blinder, MD, MS, a breast oncologist at Memorial Sloan Kettering Cancer Center, and colleagues designed a standalone financial screening intervention, Addressing Financial Needs to Improve Cancer Outcomes (AFiNICO), to compare the impact of a systematic screening intervention vs. enhanced usual care among patients with advanced cancer.
“I was thrilled to learn that our team had received this funding award from [Patient-Centered Outcomes Research Institute (PCORI)],” Blinder told Healio. “Financial hardship is a devastating problem for many patients, especially those treated with noncurative intent, for whom treatment continues for an indefinite period of time. As a result of financial hardship, patients can experience increased symptoms, decreased quality of life and shorter overall survival. Being able to address this fundamental problem of health equity will, we hope, give oncology teams the tools they need to best help their patients live longer and better lives.”
The intervention group will require patients to complete a brief monthly screening via a centralized, user-friendly platform, either online or using interactive voice response. Patient-facing staff across 10 community oncology practices will then receive automated alerts when patients “screen in,” and will then contact patients to offer appropriate resources.
The enhanced usual care group will consist of site staff receiving financial navigation training before the start of the trial, and staff will have access to informational resources to share with patients.
The study will aim to identify:
- whether monthly remote digital financial hardship screening among adults undergoing systemic therapy for advanced/metastatic cancer improves health-related quality of life, symptom burden, financial worry, treatment adherence and survival;
- how screening affects patient outcomes by identifying mediators — financial worry, treatment adherence and financial support received — and moderators — race or ethnicity, younger age, baseline level of financial worry, magnitude of out-of-pocket costs — of the effect of financial hardship screening on outcomes; and
- barriers and facilitators to implement AFiNICO and acceptability using surveys and interviews of patients, clinical care teams, site financial assistance personnel and practice leadership.
“As a leading funder of patient-centered comparative clinical effectiveness research, PCORI recognizes the evidence generated from PCORI-funded research helps patients and those who care for them make informed decisions about which health care options will work best for them,” Nakela L. Cook, MD, MPH, executive director of PCORI said in a PCORI press release. “These latest awards present significant opportunities to fill important evidence gaps across a broad range of health conditions facing millions of people living in the United States every day.”
References:
- PCORI. Longitudinal screening for financial hardship to improve outcomes in patients with advanced cancer. Available at: https://www.pcori.org/research-results/2024/longitudinal-screening-financial-hardship-improve-outcomes-patients-advanced-cancer.
- PCORI. PCORI announces $150 million in funding for new health research (press release). Available at: https://www.pcori.org/news-release/pcori-announces-150-million-funding-new-health-research. Posted April 23, 2024. Accessed April 25, 2024.
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