Telehealth financial counseling intervention may ease burden for cancer patients

For many patients diagnosed with cancer, the burden extends well beyond the clinic walls, as out-of-pocket medical costs and travel expenses add up. Many patients also lose income because they are unable to work during treatment.

In the United States, annual out-of-pocket costs for medical services for adults ages 65 and older with cancer average $2,200 to $3,823. And nearly a third of U.S. adults are unable to cover unexpected expenses of $400 with their own savings.

To address this financial burden, UF Health Cancer Center researchers created an intervention that connected UF Health cancer patients with telehealth financial counseling as part of a pilot clinical trial.

“Patients who completed the intervention reported they were satisfied and found it easy to use,” said Caterina Alacevich, Ph.D., a research assistant professor in the department of health outcomes and biomedical informatics in the UF College of Medicine and lead author of the study, published recently in the journal Cancer Causes & Control. “Our study indicates the approach is feasible to implement on a larger scale.”

More than 120 study participants were randomly placed in one of three groups: individual telehealth financial counseling, group telehealth financial counseling or usual care with educational materials. Financial counseling was provided by accredited agents from UF’s Institute of Food and Agricultural Sciences Extension program and included referrals to financial and social services.

About three-quarters of potential participants who were eligible enrolled in the study, suggesting patients with a financial burden — referred to as financial toxicity — are interested in financial counseling and valued the opportunity, the researchers said. Moreover, 75% of participants who had an initial counseling session went on to complete the intervention, indicating they found the counseling beneficial and convenient.

Nine participants who completed individual and group telehealth counseling sessions and follow-up surveys gave positive feedback on the feasibility, usefulness, ease of use, interaction and interface quality, reliability and overall satisfaction with telehealth. The findings also suggested that financial counseling may help relieve financial worries, but larger clinical trials are needed to confirm this.

“Next, we plan to study how to improve engagement and boost participant retention,” said Ramzi Salloum, Ph.D., the study’s senior author, associate director for community outreach and engagement at the UF Health Cancer Center, and an associate professor and division director in the department of health outcomes and biomedical informatics. “The use of video technology or need for reliable internet access may have presented challenges for some, so we plan to explore different frequencies and forms of interaction to improve participation. For example, involving family caregivers as participants might ease the burden on patients trying to juggle participation while undergoing treatment.”

The study was funded by the UF Health Cancer Center, which receives crucial support through the Casey DeSantis Cancer Research Act (Fla. Stat. § 381.915). Co-authors from the Cancer Center include Ji-Hyun Lee, DrPH; Erin Mobley, Ph.D.; Julia Close, M.D.; Thomas George, M.D., FACP; Jennifer LeLaurin, Ph.D.; Young-Rock Hong, Ph.D.; and Elizabeth Shenkman, Ph.D.