Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD)
Objectives To estimate the proportion and correlates of self-reported financial difficulty among patients with multiple myeloma (MM) or chronic lymphocytic leukaemia (CLL).Setting Sixty-six US community and minority oncology practices affiliated with the National Cancer Institute Community Oncology...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/6/e091769.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849735631822913536 |
|---|---|
| author | Antonia Bennett Bruce David Rapkin George J Chang Gabriela Gracia Selina Chow Heather B Neuman Stacie Dusetzina Rena M Conti Shaylene McCue Travis Dockter Heather Gunn Shelley A Jazowski Robert Behrens Paul G Richardson Niveditha Subbiah Elisa Weiss |
| author_facet | Antonia Bennett Bruce David Rapkin George J Chang Gabriela Gracia Selina Chow Heather B Neuman Stacie Dusetzina Rena M Conti Shaylene McCue Travis Dockter Heather Gunn Shelley A Jazowski Robert Behrens Paul G Richardson Niveditha Subbiah Elisa Weiss |
| author_sort | Antonia Bennett |
| collection | DOAJ |
| description | Objectives To estimate the proportion and correlates of self-reported financial difficulty among patients with multiple myeloma (MM) or chronic lymphocytic leukaemia (CLL).Setting Sixty-six US community and minority oncology practices affiliated with the National Cancer Institute Community Oncology Research Programme (NCORP).Participants A total of 521 patients (≥18 years) with MM or CLL consented and 416 responded to a survey (completion rate=79.8%). Respondents had a MM diagnosis (74.0%), an associate degree or higher (53.4%), were White (89.2%), insured (100%) and treated with clinician-administered drugs (68.0%).Study design Observational, theoretical model and protocol-based patient survey administered between May 2019 and June 2020.Primary and secondary outcome measures Financial difficulty was assessed using a single-item measure, the EORTC QLQC30: ‘Has your physical condition or medical treatment caused you financial difficulties in the past year?’ and using an ‘any-or-none’ composite measure of 22 items assessing financial difficulty, worries and the use of cost-coping strategies. Multivariable logistic regression models assessed the association of financial difficulty with diagnosis, socioeconomic and treatment characteristics.Results About 16.8% reported experiencing financial difficulty using the single-item measure and 60.3% using the composite measure. Most frequently endorsed items in the composite measure were financial worry about having to pay large medical bills related to cancer and difficulty paying medical bills. Financial difficulty using the single-item measure was associated with having MM vs CLL (adjusted OR (aOR), 0.34; 95% CI, 0.13 to 0.84; p=0.02), having insurance other than Medicare (aOR, 2.53; 95% CI, 1.37 to 4.66; p=0.003), being non-White (aOR, 2.21; 95% CI, 1.04 to 4.72; p=0.04) and having a high school education or below (aOR, 0.36; 95% CI, 0.21 to 0.64; p=0.001). Financial difficulty using the composite measure was associated with having a high school education or below (aOR, 0.62; 95% CI, 0.41 to 0.94; p=0.03).Conclusions US patients with MM and CLL report financial difficulty, especially those with low socio-economic status. Interventions are needed to mitigate patients’ financial difficulty.Trial registration number NCT03870633. |
| format | Article |
| id | doaj-art-c9e352de0d2d4fe5b41180a21ff312ba |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c9e352de0d2d4fe5b41180a21ff312ba2025-08-20T03:07:31ZengBMJ Publishing GroupBMJ Open2044-60552025-06-0115610.1136/bmjopen-2024-091769Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD)Antonia Bennett0Bruce David Rapkin1George J Chang2Gabriela Gracia3Selina Chow4Heather B Neuman5Stacie Dusetzina6Rena M Conti7Shaylene McCue8Travis Dockter9Heather Gunn10Shelley A Jazowski11Robert Behrens12Paul G Richardson13Niveditha Subbiah14Elisa Weiss15Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USAEpiemiology and Population Health, Albert Einsein College of Medicine, Bronx, New York, UKDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USAUniversity of Illinois Chicago, Chicago, Illinois, USAAlliance Protocol Operations Office, University of Chicago, Chicago, IL, Chicago, Illinois, USAUniversity of Wisconsin, Madison, Wisconsin, USAHealth Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USABoston University, Boston, Massachusetts, USAMayo Clinic Research Rochester, Rochester, Minnesota, USAMayo Clinic Research Rochester, Rochester, Minnesota, USAMayo Clinic Research Rochester, Rochester, Minnesota, USAVanderbilt University School of Medicine, Nashville, Tennessee, USAIowa Wide Oncology Research Coalition, Des Moines, IA, Des Moines, Iowa, USADana-Farber Cancer Institute, Boston, Massachusetts, USACancer Control Program, Alliance NCTN Foundation, Chicago, Illinois, Chicago, Illinois, USALeukemia and Lymphoma Society, Rye Brook, New York, USAObjectives To estimate the proportion and correlates of self-reported financial difficulty among patients with multiple myeloma (MM) or chronic lymphocytic leukaemia (CLL).Setting Sixty-six US community and minority oncology practices affiliated with the National Cancer Institute Community Oncology Research Programme (NCORP).Participants A total of 521 patients (≥18 years) with MM or CLL consented and 416 responded to a survey (completion rate=79.8%). Respondents had a MM diagnosis (74.0%), an associate degree or higher (53.4%), were White (89.2%), insured (100%) and treated with clinician-administered drugs (68.0%).Study design Observational, theoretical model and protocol-based patient survey administered between May 2019 and June 2020.Primary and secondary outcome measures Financial difficulty was assessed using a single-item measure, the EORTC QLQC30: ‘Has your physical condition or medical treatment caused you financial difficulties in the past year?’ and using an ‘any-or-none’ composite measure of 22 items assessing financial difficulty, worries and the use of cost-coping strategies. Multivariable logistic regression models assessed the association of financial difficulty with diagnosis, socioeconomic and treatment characteristics.Results About 16.8% reported experiencing financial difficulty using the single-item measure and 60.3% using the composite measure. Most frequently endorsed items in the composite measure were financial worry about having to pay large medical bills related to cancer and difficulty paying medical bills. Financial difficulty using the single-item measure was associated with having MM vs CLL (adjusted OR (aOR), 0.34; 95% CI, 0.13 to 0.84; p=0.02), having insurance other than Medicare (aOR, 2.53; 95% CI, 1.37 to 4.66; p=0.003), being non-White (aOR, 2.21; 95% CI, 1.04 to 4.72; p=0.04) and having a high school education or below (aOR, 0.36; 95% CI, 0.21 to 0.64; p=0.001). Financial difficulty using the composite measure was associated with having a high school education or below (aOR, 0.62; 95% CI, 0.41 to 0.94; p=0.03).Conclusions US patients with MM and CLL report financial difficulty, especially those with low socio-economic status. Interventions are needed to mitigate patients’ financial difficulty.Trial registration number NCT03870633.https://bmjopen.bmj.com/content/15/6/e091769.full |
| spellingShingle | Antonia Bennett Bruce David Rapkin George J Chang Gabriela Gracia Selina Chow Heather B Neuman Stacie Dusetzina Rena M Conti Shaylene McCue Travis Dockter Heather Gunn Shelley A Jazowski Robert Behrens Paul G Richardson Niveditha Subbiah Elisa Weiss Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD) BMJ Open |
| title | Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD) |
| title_full | Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD) |
| title_fullStr | Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD) |
| title_full_unstemmed | Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD) |
| title_short | Observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at US community oncology clinics (Alliance A231602CD) |
| title_sort | observational survey of financial difficulties among patients with multiple myeloma and chronic lymphocytic leukaemia treated at us community oncology clinics alliance a231602cd |
| url | https://bmjopen.bmj.com/content/15/6/e091769.full |
| work_keys_str_mv | AT antoniabennett observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT brucedavidrapkin observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT georgejchang observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT gabrielagracia observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT selinachow observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT heatherbneuman observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT staciedusetzina observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT renamconti observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT shaylenemccue observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT travisdockter observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT heathergunn observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT shelleyajazowski observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT robertbehrens observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT paulgrichardson observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT nivedithasubbiah observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd AT elisaweiss observationalsurveyoffinancialdifficultiesamongpatientswithmultiplemyelomaandchroniclymphocyticleukaemiatreatedatuscommunityoncologyclinicsalliancea231602cd |