Cancer survivors' experiences with financial toxicity: A systematic review and meta‐synthesis of qualitative studies

Abstract

Objective The aim of this study was to synthesize qualitative research evidence on cancer survivors' experiences with financial toxicity (FT). Methods We carried out a systematic review of qualitative studies using a meta‐aggregation approach. Papers published prior to 31 August 2019, were collected from electronic databases, including PubMed/MEDLINE, MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), Web of Science, ProQuest Dissertations and Theses, and Cochrane Library (Wiley). Results Six synthesized findings were derived from 14 studies covering cancer patients' awareness of FT, cancer‐related expenditures, and the risk factors, impacts, coping strategies, and unmet needs related to FT. Conclusions Cancer survivors incur FT; however, their awareness of FT is limited. Cancer‐related FT has multiple impacts on survivors' lives. Although cancer survivors try to cope with FT through adjustments, they still have unmet needs for the management of FT. Nurses and social workers can play a critical role in helping survivors manage FT by increasing pre‐awareness of FT, strengthening emotional empowerment, and providing personalized informative support.

Translation and validation of the Traditional Chinese version of the COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (Version 2)

“…5 Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong, China. 6 School of Nursing, Queensland University of Technology, Brisbane, Australia. 7 Princess Alexandra Hospital, Metro South Health, Brisbane, Australia.…”

“…The objective and subjective burdens of this financial distress in the context of cancer have been termed 'financial toxicity' [4]. A high level of financial toxicity has been demonstrated to increase patients' symptom burden [5] and reduce their compliance to therapy, health-related quality of life (HRQoL) and survival rate [2,6]. Therefore, financial issues in the cancer care setting must be discussed to prevent these negative outcomes.…”

“…Although several studies have examined financial toxicity among cancer patients [6], such data are lacking for the Chinese population. In particular, no suitable instrument was available for such measurement in traditional Chinese.…”

Exploring the role of general practitioners in addressing financial toxicity in cancer patients

“…The diagnosis and treatment of cancer come with a substantial financial burden for the patient, their family, and the community [1][2][3][4][5][6] with the cascade of costs associated with cancer varying from diagnosis through to the end of treatment and beyond [7]. A recent systematic review identified this financial burden as significant in countries with private healthcare systems, universal public healthcare systems, or hybrid systems [8].…”

“…A recent systematic review including 25 studies of 271,732 cancer survivors reported the frequency of FT ranging from 28 to 48% using monetary measures such as percentage of household income and ranged from 16 to 73% using selfreport measures such as impacts on everyday living expenses [9]. Although FT has gained attention due to the high cost of drugs, it is now recognised that patients are affected by other costs associated with a cancer diagnosis such as transportation, absenteeism from work during treatment, supportive care, complementary, and alternative therapies [6]. A limited ability to return to work is also an ongoing issue [6,15].…”