Recommendations from clinical practice guidelines on discussion of costs of care in adult patients with advanced cancer: A systematic review.

Authors

null

Anupriya Agarwal

University of Sydney, Camperdown, NSW, Australia

Anupriya Agarwal , Deme John Karikios , Martin R. Stockler , Philip James Beale , Rachael L. Morton

Organizations

University of Sydney, Camperdown, NSW, Australia, Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, Australia, Chris O'Brien Life House, Camperdown, Australia, Melanoma Institute Australia, NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia

Research Funding

Other

Background: Optimising the care of cancer patients without imposing significant financial burden related to their anticancer treatment is becoming increasingly difficult. The 2009 American Society of Clinical Oncology’s (ASCO) Guidance Statement on the Cost of Cancer Care recommends that ‘patient-physician discussions regarding the cost of care are an important component of high-quality care’.(1) We sought information for oncologists to facilitate patient-clinician communication about the costs of care in published clinical practice guidelines (CPGs). Methods: We searched MEDLINE, EMBASE and multiple databases of CPG from January 2008 to 1st June 2018 for recommendations about discussing the costs of care. We assessed quality with the AGREE II instrument for the assessment of guidelines. Results: We identified 471 publications, of which 25 guidelines met our eligibility criteria. Most guidelines were from ASCO (64%, 16/25) and the Scottish Intercollegiate Guidelines Network (SIGN, 24%, 6/25). Guidelines included recommendations on discussion or consideration of treatment costs when prescribing in 52% (13/25) with information about actual costs in only 20% (5/25). Recognition of the risk of financial burden or financial toxicity was described in 60% (15/25) of guidelines, however, only a minority of these, 28% (7/25) contained information regarding management of patients with financial concerns. Conclusions: Current CPGs have limited information to guide patient-clinician communication about the costs of anticancer treatment and management of financial burden. Future guidelines should contain more information about the optimal timing, frequency, and content of these discussions. Future guidelines should include more guidance about how oncologists should communicate the costs of care accurately and transparently, along with suggestions to reduce financial burden.

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Symptoms and Survivorship: Publication Only

Track

Symptom Science and Palliative Care

Sub Track

Psychosocial and Communication Research

Citation

J Clin Oncol 37, 2019 (suppl; abstr e23175)

DOI

10.1200/JCO.2019.37.15_suppl.e23175

Abstract #

e23175

Abstract Disclosures

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