Financial concerns about participation in clinical trials among patients with cancer

Yu Ning Wong*, Mark D. Schluchter, Terrance L. Albrecht, Al Bowen Benson, Joanne Buzaglo, Michael Collins, Anne Lederman Flamm, Linda Fleisher, Michael Katz, Tyler G. Kinzy, Tasnuva M. Liu, Sharon Manne, Seunghee Margevicius, Dawn M. Miller, Suzanne M. Miller, David Poole, Stephanie Raivitch, Nancy Roach, Eric Ross, Neal J. Meropol

*Corresponding author for this work

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Purpose: The decision to enroll in a clinical trial is complex given the uncertain risks and benefits of new approaches. Many patients also have financial concerns. We sought to characterize the association between financial concerns and the quality of decision making about clinical trials. Methods: Weconducted a secondary data analysis of a randomized trial of aWeb-based educational tool (Preparatory Education About Clinical Trials) designed to improve the preparation of patients with cancer for making decisions about clinical trial enrollment. Patients completed a baseline questionnaire that included three questions related to financial concerns (five-point Likert scales): "Howmuch of a burden on you is the cost of your medical care?," "I'mafraid that my health insurancewon't pay for a clinical trial," and "I'mworried that I wouldn't be able to afford the costs of treatment on a clinical trial." Results were summed, with higher scores indicating greater concerns.We usedmultiple linear regressions tomeasure the association between concerns and self-reported measures of self-efficacy, preparation for decision making, distress, and decisional conflict in separate models, controlling for sociodemographic characteristics. Results: One thousand two hundred eleven patients completed at least one financial concern question. Of these, 27% were 65 years or older, 58% were female, and 24% had a high school education or less. Greater financial concern was associated with lower self-efficacy and preparation for decision making, as well as with greater decisional conflict and distress, even after adjustment for age, race, sex, education, employment, and hospital location (P <.001 for all models). Conclusion: Financial concerns are associated with several psychological constructs that may negatively influence decision quality regarding clinical trials. Greater attention to patients' financial needs and concerns may reduce distress and improve patient decision making.

Original languageEnglish (US)
Pages (from-to)479-487
Number of pages9
JournalJournal of Clinical Oncology
Volume34
Issue number5
DOIs
StatePublished - Feb 10 2016

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Wong, Y. N., Schluchter, M. D., Albrecht, T. L., Benson, A. B., Buzaglo, J., Collins, M., Flamm, A. L., Fleisher, L., Katz, M., Kinzy, T. G., Liu, T. M., Manne, S., Margevicius, S., Miller, D. M., Miller, S. M., Poole, D., Raivitch, S., Roach, N., Ross, E., & Meropol, N. J. (2016). Financial concerns about participation in clinical trials among patients with cancer. Journal of Clinical Oncology, 34(5), 479-487. https://doi.org/10.1200/JCO.2015.63.2463