Characteristics associated with inter-individual variability in financial distress in patients with breast cancer prior to and for 12 months following surgery

Raymond Javan Chan, Bruce Cooper, Bogda Koczwara, Alexandre Chan, Chia Jie Tan, Louisa Gordon, Steven M. Paul, Laura B. Dunn, Yvette P. Conley, Kord M. Kober, Gary Abrams, Jon D. Levine, Christine Miaskowski

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate for inter-individual differences in financial distress and identify demographic, clinical, and symptom characteristics associated with higher levels of financial distress. Methods: Patients (n = 387) were enrolled prior to breast cancer surgery and followed for 12 months. Financial distress was measured using a 0 (no problem) to 10 (severe problem) numeric rating scale. Hierarchical linear modeling was used to evaluate for inter-individual differences in trajectories of financial distress and characteristics associated with financial distress at enrollment and over 12 months. Results: Patients’ mean age was 55.0 (± 11.7) years and the majority underwent breast conservation surgery (80.6%). Mean financial distress score prior to surgery was 3.3 (± 3.4; range 0 to 10). Unconditional model for financial distress demonstrated no significant changes over time (-0.006/month). Younger age, lower income, receipt of an axillary lymph node dissection and adjuvant chemotherapy, and lower attentional function were associated with higher preoperative levels of financial distress. Conclusion: Risk factors identified in this study can be used to inform clinicians regarding the need to initiate financial discussions and social work referrals for some patients. Additional clinical or system level interventions should be considered for vulnerable groups with these risk factors.

Original languageEnglish
Number of pages10
JournalSupportive Care in Cancer
Early online date3 Sep 2021
DOIs
Publication statusE-pub ahead of print - 3 Sep 2021

Keywords

  • Breast cancer
  • Financial burden
  • Financial distress
  • Financial toxicity
  • Hierarchical linear modeling

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