Mobile Application to Identify Cancer Treatment-Related Financial Assistance: Results of a Randomized Controlled Trial.

Autor:	Tarnasky AM; Duke University School of Medicine, Durham, NC., Tran GN; Duke University School of Medicine, Durham, NC., Nicolla J; Duke Cancer Institute, Durham, NC., Friedman FAP; Duke Cancer Institute, Durham, NC., Wolf S; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC., Troy JD; Department of Pediatrics, Duke University, Durham, NC., Sung AD; Duke University School of Medicine, Durham, NC.; Duke Cancer Institute, Durham, NC., Shah K; NYU Grossman School of Medicine, New York, NY., Oury J; Duke Cancer Institute, Durham, NC., Thompson JC; Duke Cancer Institute, Durham, NC., Gagosian B; Vivor, LLC, New York, NY., Pollak KI; Duke University School of Medicine, Durham, NC.; Duke Cancer Institute, Durham, NC., Manners I; Vivor, LLC, New York, NY., Zafar SY; Duke University School of Medicine, Durham, NC.; Duke Cancer Institute, Durham, NC.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2021 Oct; Vol. 17 (10), pp. e1440-e1449. Date of Electronic Publication: 2021 Apr 02.
DOI:	10.1200/OP.20.00757
Abstrakt:	Purpose: Insured patients with cancer face high treatment-related, out-of-pocket (OOP) costs and often cannot access financial assistance. We conducted a randomized, controlled trial of Bridge, a patient-facing app designed to identify eligible financial resources for patients. We hypothesized that patients using Bridge would experience greater OOP cost reduction than controls. Methods: We enrolled patients with cancer who had OOP expenses from January 2018 to March 2019. We randomly assigned patients 1:1 to intervention (Bridge) versus control (financial assistance educational websites). Primary and secondary outcomes were self-reported OOP costs and subjective financial distress 3 months postenrollment. In post hoc analyses, we analyzed application for and receipt of financial assistance at 3 months postenrollment. We used chi-square, Mann-Whitney tests, and logistic regression to compare study arms. Results: We enrolled 200 patients. The median age was 57 years (IQR, 47.0-63.0). Most patients had private insurance (71%), and the median household income was $62,000 in US dollars (USD) (IQR, $36,000-$100,000 [USD]). Substantial missing data precluded assessment of primary and secondary outcomes. In post hoc analyses, patients in the Bridge arm were more likely than controls to both apply for and receive financial assistance. Conclusion: We were unable to test our primary outcome because of excessive missing follow-up survey data. In exploratory post hoc analyses, patients who received a financial assistance app were more likely to apply for and receive financial assistance. Ultimately, our study highlights challenges faced in identifying measurable outcomes and retaining participants in a randomized, controlled trial of a mobile app to alleviate financial toxicity. Competing Interests: Jonathan NicollaEmployment: Prepped HealthLeadership: Prepped Health, Acclivity HealthStock and Other Ownership Interests: Prepped HealthConsulting or Advisory Role: Acclivity HealthPatents, Royalties, Other Intellectual Property: Receive royalties from Duke University for which I am listed on Inventor Disclosure Forms filed within the university for the creation of mobile health applications Jesse D. TroyHonoraria: Gamida Cell, Synthetic BiologicsConsulting or Advisory Role: The EMMES Corporation, AegisCN, Cohortias, Gamida CellResearch Funding: Seattle Genetics, Bristol-Myers SquibbPatents, Royalties, Other Intellectual Property: 16/493,754 (pending), 16/477,110, 2019-549537 (pending), 10-2019-7029841 (pending), PCT/US2018/022174, PCT/US2018/013623,62/470,431, Royalties from SinoCell Technologies, IncOther Relationship: Community Data Roundtable Anthony D. SungConsulting or Advisory Role: CelltrionResearch Funding: Novartis, Cellective, Merck, Seres Therapeutics, Enterome Ben GagosianEmployment: Vivor LLCStock and Other Ownership Interests: Vivor LLC Ian MannersEmployment: VivorLeadership: VivorStock and Other Ownership Interests: Vivor S. Yousuf ZafarEmployment: Shattuck LabsStock and Other Ownership Interests: Shattuck LabsConsulting or Advisory Role: AIM Specialty Health, McKesson, RTI Health Solutions, Discern Health, WIRB-Copernicus GroupResearch Funding: AstraZeneca(OPTIONAL) Uncompensated Relationships: Vivor, Family Reach FoundationNo other potential conflicts of interest were reported.
Databáze:	MEDLINE
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