Financial concerns about participation in clinical trials among patients with cancer

Yu Ning Wong*, Mark D. Schluchter, Terrance L. Albrecht, Al B Benson III, 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

10 Citations (Scopus)

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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Clinical Trials
Decision Making
Neoplasms
Self Efficacy
Health Care Costs
Education
Sex Education
Linear Models
Psychology
Health
Conflict (Psychology)

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Wong, Y. N., Schluchter, M. D., Albrecht, T. L., Benson III, A. B., Buzaglo, J., Collins, M., ... 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
Wong, Yu Ning ; Schluchter, Mark D. ; Albrecht, Terrance L. ; Benson III, Al B ; Buzaglo, Joanne ; Collins, Michael ; Flamm, Anne Lederman ; Fleisher, Linda ; Katz, Michael ; Kinzy, Tyler G. ; Liu, Tasnuva M. ; Manne, Sharon ; Margevicius, Seunghee ; Miller, Dawn M. ; Miller, Suzanne M. ; Poole, David ; Raivitch, Stephanie ; Roach, Nancy ; Ross, Eric ; Meropol, Neal J. / Financial concerns about participation in clinical trials among patients with cancer. In: Journal of Clinical Oncology. 2016 ; Vol. 34, No. 5. pp. 479-487.
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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.",
author = "Wong, {Yu Ning} and Schluchter, {Mark D.} and Albrecht, {Terrance L.} and {Benson III}, {Al B} and Joanne Buzaglo and Michael Collins and Flamm, {Anne Lederman} and Linda Fleisher and Michael Katz and Kinzy, {Tyler G.} and Liu, {Tasnuva M.} and Sharon Manne and Seunghee Margevicius and Miller, {Dawn M.} and Miller, {Suzanne M.} and David Poole and Stephanie Raivitch and Nancy Roach and Eric Ross and Meropol, {Neal J.}",
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Wong, YN, Schluchter, MD, Albrecht, TL, Benson III, AB, Buzaglo, J, Collins, M, Flamm, AL, Fleisher, L, Katz, M, Kinzy, TG, Liu, TM, Manne, S, Margevicius, S, Miller, DM, Miller, SM, Poole, D, Raivitch, S, Roach, N, Ross, E & Meropol, NJ 2016, 'Financial concerns about participation in clinical trials among patients with cancer', Journal of Clinical Oncology, vol. 34, no. 5, pp. 479-487. https://doi.org/10.1200/JCO.2015.63.2463

Financial concerns about participation in clinical trials among patients with cancer. / Wong, Yu Ning; Schluchter, Mark D.; Albrecht, Terrance L.; Benson III, Al B; Buzaglo, Joanne; Collins, Michael; Flamm, Anne Lederman; Fleisher, Linda; Katz, Michael; Kinzy, Tyler G.; Liu, Tasnuva M.; Manne, Sharon; Margevicius, Seunghee; Miller, Dawn M.; Miller, Suzanne M.; Poole, David; Raivitch, Stephanie; Roach, Nancy; Ross, Eric; Meropol, Neal J.

In: Journal of Clinical Oncology, Vol. 34, No. 5, 10.02.2016, p. 479-487.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Financial concerns about participation in clinical trials among patients with cancer

AU - Wong, Yu Ning

AU - Schluchter, Mark D.

AU - Albrecht, Terrance L.

AU - Benson III, Al B

AU - Buzaglo, Joanne

AU - Collins, Michael

AU - Flamm, Anne Lederman

AU - Fleisher, Linda

AU - Katz, Michael

AU - Kinzy, Tyler G.

AU - Liu, Tasnuva M.

AU - Manne, Sharon

AU - Margevicius, Seunghee

AU - Miller, Dawn M.

AU - Miller, Suzanne M.

AU - Poole, David

AU - Raivitch, Stephanie

AU - Roach, Nancy

AU - Ross, Eric

AU - Meropol, Neal J.

PY - 2016/2/10

Y1 - 2016/2/10

N2 - 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.

AB - 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.

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