Health Services Research

SS 11 - HSR 1

78 - Use of a Validated Patient-Reported Scoring System to Assess Financial Toxicity in Radiation Oncology Patients

Monday, October 22
7:55 AM - 8:05 AM
Location: Room 007 A/B

Use of a Validated Patient-Reported Scoring System to Assess Financial Toxicity in Radiation Oncology Patients
K. A. D'Rummo1, L. Miller1, M. J. Tennapel2, and X. Shen1; 1University of Kansas School of Medicine, Department of Radiation Oncology, Kansas City, KS, 2Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS

Purpose/Objective(s): The financial consequence of cancer treatment may impact quality of life and survival in patients with cancer. A recently developed patient-reported measure of financial toxicity, the COmprehensive Score of financial Toxicity (COST), has been validated in the medical oncology among patients with metastatic cancer. Here, we aim to assess the performance of the COST tool in the radiation oncology setting. We hypothesize that financial toxicity is prevalent in patients treated with radiation therapy, and financial toxicity is associated with age and insurance status.

Materials/Methods: From Jan. 16 to Feb. 9, 2018, consecutive patients of a single radiation oncology clinic were asked to participate. Participants completed a COST-Functional Assessment of Chronic Illness Therapy (COST-FACIT) questionnaire, as described in previous literature. Total possible scores range from 0-44, with a lower score indicating worse toxicity. Raw COST scores were collected along with information regarding patient demographics, insurance, diagnosis, and radiation treatment. Linear regression models were generated to identify factors associated with distress. All analyses were performed using SAS 9.3 software with two-tailed p-values reported and a p-value of <0.05 considered significant.

Results: A total of 167 patients completed the COST-FACIT questionnaire and were included. In total, 10% of participants reported COST scores in the lowest quartile of possible scores, indicating severe financial distress. The mean score ± standard deviation of our total population was 21.86 ± 9.26, comparable to previously-reported mean COST scores of 21.60 ± 12.65 and 22.34 ± 11.79 in patients at two medical oncology institutions. There was a trend towards greater financial distress in patients under the age of 65 (p =.076) and in non-married patients (p =.093). Given strong correlation between Medicare eligibility and age, it was not possible to separate out insurance status as an associated factor. Race, insurance type, and intent of radiation treatment (curative vs palliative) were not associated with worse financial distress. COST scores did not differ between metastatic and non-metastatic patients (p =.83). Scores did not vary by time interval from initial diagnosis or time interval from completion of radiation therapy.

Conclusion: To our knowledge, this is the first application of the patient-reported COST to a radiation oncology population. The COST tool performs similarly in chemotherapy and radiation oncology settings, and is able to identify patients with a high level of financial distress. Possible determinants of financial toxicity in this population include age and marital status. Additional work will be done in validation and to ultimately attach measures of financial distress as a patient reported outcome in future treatment studies.

Author Disclosure: K.A. D'Rummo: None. L. Miller: None. M.J. Tennapel: None. X. Shen: None.

Kevin D'Rummo, MD

Disclosure:
Employment
University of Kansas Medical Center: Resident: Employee

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