Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy.
Jeremy P Harris, Eric Ku, Garrett Harada and 7 others
PMID 37406195WHAT IT FOUND
Financial hardship affected 45% of 53 patients before palliative radiation, and higher financial toxicity was linked to worse emotional, social, physical, role, and cognitive quality of life.
Key findings
01Among 53 patients, median COST was 25 (range 0-44), and 49%, 32%, 15%, and 4% had grade 0, 1, 2, and 3 financial toxicity.
02More financial toxicity was associated with lower emotional functioning (rho = -.61, P < .0001) and lower social functioning (rho = -.44, P = .001).
03Higher area income was inversely associated with financial toxicity (rho = -.45, P = .0006), and the final adjusted model included higher area income (HR .80, P = .007) and higher cognitive functioning (HR .96, P = .01).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Single-center retrospective study of only 53 patients, so the estimates are imprecise and the model may have been overfitted. The survey was administered only in English, and all patients had some form of health insurance, so uninsured and non-English-speaking patients were not represented. Area income was used as a proxy for socioeconomic status and may not adequately describe each patient's income. The COST grading system has generally not been used clinically. Selection, response, and measurement bias are possible because the data came from a single cancer center and routine clinical surveys. The study occurred after the pandemic began, so it cannot show how financial toxicity changed over time.
Declared interests
The authors declared no potential conflicts of interest and received no financial support.
The easy way to misread this
Do not read the associations as proof that palliative radiation causes financial toxicity or that cost screening improves outcomes. This was a small retrospective survey of 53 insured, English-speaking patients, and it measured associations, not treatment effects.