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

Abstract

Purpose Financial toxicity (FT) describes financial distress or hardship as an outcome of cancer and its treatment. Minimising the impact of FT requires early assessment and intervention. General practice plays a significant role in the support of a person with cancer and may have an important role in the management of FT. The purpose of this study was to understand perspectives of general practitioners (GP) on addressing FT in the primary care setting, which may then help inform strategies to further support collaborative efforts to address FT. Methods A qualitative interpretive approach was utilised for this study. GPs were recruited through a GP conference and other professional networks using purposive, snowballing sampling techniques. Data collection continued until sufficient rich data had been obtained. Interviews were recorded and transcribed verbatim. The data were analysed using inductive analysis techniques. Results Twenty (n = 20) GPs participated in semi-structured in-depth telephone interviews. GPs identified that their role positions them well to provide some FT support, but there are limitations. Perceptions and philosophies about cancer management were drivers of referrals and financial conversations. Priorities for care of FT by GPs included improved cost information provision and accessible support. Conclusion GPs can play an important role in helping to address FT associated with cancer and its treatments if supported with the right information.

Supportive care of patients diagnosed with high grade glioma and their carers in Australia

“…A recent RCT testing an intervention to improve continuity of care between oncology and family practice teams, reported better continuity of information and management [ 39 ]. GPs could provide an important service for HGG patients and their carers, particularly for those managing difficult or changing symptoms, for financial concerns, and links to appropriate services [ 40 ].…”

Opinions and strategies of Australian health professionals on tackling cancer‐related financial toxicity: A nationwide survey

“…Opinions varied on whose role was best suited to discussing financial toxicity, both in our and previous studies. Patients are in favor of having a physician as part of the cost of care discussion, 13,24 even if it does not influence treatment decisions, 35 and these discussions are relevant for both direct medical out‐of‐pocket costs and broader indirect costs (employment losses, travel/accommodation costs, etc.). Other studies state physicians are not appropriate to discuss financial concerns, 32,36 and instead identify social workers and financial advisors as the most suitable 37 .…”

“…These studies mostly focus on discussions about costs and communication 12 and often involve single‐center studies with small samples of clinicians 12 . In general, studies involve oncologists and few have addressed the perspectives of various health professionals’ roles in mitigating financial hardship, the barriers faced, and practices currently taken 10,13 . In addition to communication of costs and financial impacts, there is a wide range of potential actions for alleviating financial toxicity, which can be shared within the cancer care team.…”

“…9 However, from a clinical viewpoint, although sev-eral national institutions recommend physician-patient discussions about the costs of anticancer treatment and management of financial burden, 10,11 there is little information to guide such discussions. 12 Physician-patient conversations on the cost of care are emerging as a key component of high-quality cancer care 12 and health professionals are well-positioned to directly engage their patients in discussions 10,13 on health insurance coverage, 14 ways of reducing out-of-pocket costs and cost-saving strategies without necessarily changing the care plan. 14 These discussions can often influence treatment decisions, 15 improve treatment adherence, 16 and reduce patient expenses and associated distress.…”

Yonder: Primary aldosteronism, artificial intelligence, irritable bowel syndrome, and financial toxicity

“…Financial toxicity (FT) describes financial distress or hardship as an outcome of cancer and its treatment. Given that GPs play a significant role in the support of persons with cancer, a recent Australian study aimed to understand their perspectives on addressing FT. 4 Many GPs felt they have the expertise to play a role in supporting FT in patients with cancer, but there are limitations to the extent of this role. These limitations include knowledge of cost, complexity of cancer care, role in the multidisciplinary team, and varying perceptions of health service and care provision.…”