DISCO: A Patient Intervention to Reduce the Financial Burden of Cancer

Clinicaltrials.gov ID: NCT04766190

Status RECRUITING

Phase NA

Age ≥ 18 Years

Enrollments 260

Conditions

Financial Toxicity, Cancer, Question Prompt List, Breast Cancer, Prostate Cancer

Summary

The DISCO App is designed to improve, during the interaction, patient active participation and patient-initiated oncologist treatment cost discussions, and, in the short term, patient's treatment cost knowledge, self-efficacy for managing both cost and physician interactions, referrals, perceived financial toxicity (i.e., distress and material hardship); in turn, these will affect longer-term outcomes of financial toxicity and adherence.

Detailed Description

This work is based on the core scientific premise – that increasing patient active participation and the frequency and quality of treatment cost discussions will decrease the short- and longer-term burdens of financial toxicity through their influence on self-efficacy for managing treatment cost. The focus is on patient self-efficacy for managing treatment cost because it is expected that improved treatment cost education and patient-oncologist treatment cost discussions prompted by the DISCO App will directly improve the self-efficacy needed for patients to proactively manage treatment costs, thus reducing the material and psychological burden of financial toxicity. The DISCO App is not designed to increase patients’ ability to pay or reduce the cost of treatment, but it may benefit patients by increasing: their knowledge of treatment costs, their self-efficacy for managing cost, and the likelihood they receive financial and psychological assistance and support. This research is significant because, if successful, reducing the material and psychological burden of financial toxicity will improve the quality of care and work toward achieving health equity. The DISCO App has already been tested for its feasibility and acceptability. The DISCO App will now be tested for its effectiveness in a diverse population of people with solid tumors treated with IV and oral chemotherapies.

Locations

1 location Found with status Recruiting

Status

RECRUITING

Contact Person

Lauren Hamel, PhD
313-576-9672
[email protected]

Principal Investigator

Lauren Hamel, PhD

Eligibility Criteria

Inclusion Criteria:

* Oncologists are eligible if they treat patients with breast, prostate, lung, or colorectal cancers at Karmanos Cancer Institute. Data from oncologists will include their self-report data and video-recorded treatment discussions with participating patients.
* Patients: Must be able to read and write in English; have an email account; and are newly diagnosed with breast, prostate, lung or colorectal cancer (stage I-IV) for which systemic therapy is a likely recommended treatment. Data from patients will include their self-report data, video-recorded treatment discussions with participating oncologists, and medical record data

Exclusion Criteria:

-

Outcome Measures

Primary Outcome Measures

Self-efficacy in patient-physician interactions. An example item from the PEPPI scale: How confident are you in your ability to know what questions to ask your doctor? Data will be aggregated using means and standard deviations.

Time Frame: Immediately after the video-recorded patient-physician interaction

Self-efficacy in managing treatment costs An example item from adapted scale: I am confident I can pay for the direct costs of my treatment. Data will be aggregated using means and standard deviations.

Time Frame: Immediately after video-recorded patient-physician interaction

Knowledge of types of treatment cost An example item from the original measure: Cancer treatment may cost me in the following ways? Data will be aggregated using frequency counts.

Time Frame: Immediately after video-recorded patient-physician interaction

Perceived financial toxicity; Scale title: Adapted Comprehensive score for financial toxicity (COST) measure.

Time Frame: Immediately after video-recorded patient-physician interaction

Perceived presence of treatment cost discussion

Time Frame: Immediately after video-recorded patient-physician interaction

Patient self-report of level of satisfaction with any treatment cost discussions with physician assessed via an original scale: satisfaction with any treatment cost discussed with the physician that occurred.

Time Frame: Immediately after video-recorded patient-physician interaction

The observed frequency of a cost discussion assessed via an original coding system. Frequency is assessed as the number of distinct cost discussions that occur in each recorded interaction. Higher is a better outcome.

Time Frame: During the video-recorded patient-physician interaction

Patient-Centered Communication scale. The observed quality of patient-physician communication assessed a validated coding system. Minimum = 1; Maximum =5; higher is a better outcome

Time Frame: During the video-recorded patient-physician interaction