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Patient-oncologist cost communication, financial distress, and medication adherence.

Publication ,  Journal Article
Bestvina, CM; Zullig, LL; Rushing, C; Chino, F; Samsa, GP; Altomare, I; Tulsky, J; Ubel, P; Schrag, D; Nicolla, J; Abernethy, AP; Zafar, SY ...
Published in: J Oncol Pract
May 2014

BACKGROUND: Little is known about the association between patient-oncologist discussion of cancer treatment out-of-pocket (OOP) cost and medication adherence, a critical component of quality cancer care. METHODS: We surveyed insured adults receiving anticancer therapy. Patients were asked if they had discussed OOP cost with their oncologist. Medication nonadherence was defined as skipping doses or taking less medication than prescribed to make prescriptions last longer, or not filling prescriptions because of cost. Multivariable analysis assessed the association between nonadherence and cost discussions. RESULTS: Among 300 respondents (86% response), 16% (n = 49) reported high or overwhelming financial distress. Nineteen percent (n = 56) reported talking to their oncologist about cost. Twenty-seven percent (n = 77) reported medication nonadherence. To make a prescription last longer, 14% (n = 42) skipped medication doses, and 11% (n = 33) took less medication than prescribed; 22% (n = 66) did not fill a prescription because of cost. Five percent (n = 14) reported chemotherapy nonadherence. To make a prescription last longer, 1% (n = 3) skipped chemotherapy doses, and 2% (n = 5) took less chemotherapy; 3% (n = 10) did not fill a chemotherapy prescription because of cost. In adjusted analyses, cost discussion (odds ratio [OR] = 2.58; 95% CI, 1.14 to 5.85; P = .02), financial distress (OR = 1.64, 95% CI, 1.38 to 1.96; P < .001) and higher financial burden than expected (OR = 2.89; 95% CI, 1.41 to 5.89; P < .01) were associated with increased odds of nonadherence. CONCLUSION: Patient-oncologist cost communication and financial distress were associated with medication nonadherence, suggesting that cost discussions are important for patients forced to make cost-related behavior alterations. Future research should examine the timing, content, and quality of cost-discussions.

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Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

May 2014

Volume

10

Issue

3

Start / End Page

162 / 167

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Physician-Patient Relations
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medication Adherence
  • Male
  • Humans
  • Female
  • Disclosure
  • Cross-Sectional Studies
 

Citation

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MLA
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Bestvina, C. M., Zullig, L. L., Rushing, C., Chino, F., Samsa, G. P., Altomare, I., … Zafar, S. Y. (2014). Patient-oncologist cost communication, financial distress, and medication adherence. J Oncol Pract, 10(3), 162–167. https://doi.org/10.1200/JOP.2014.001406
Bestvina, Christine M., Leah L. Zullig, Christel Rushing, Fumiko Chino, Gregory P. Samsa, Ivy Altomare, James Tulsky, et al. “Patient-oncologist cost communication, financial distress, and medication adherence.J Oncol Pract 10, no. 3 (May 2014): 162–67. https://doi.org/10.1200/JOP.2014.001406.
Bestvina CM, Zullig LL, Rushing C, Chino F, Samsa GP, Altomare I, et al. Patient-oncologist cost communication, financial distress, and medication adherence. J Oncol Pract. 2014 May;10(3):162–7.
Bestvina, Christine M., et al. “Patient-oncologist cost communication, financial distress, and medication adherence.J Oncol Pract, vol. 10, no. 3, May 2014, pp. 162–67. Pubmed, doi:10.1200/JOP.2014.001406.
Bestvina CM, Zullig LL, Rushing C, Chino F, Samsa GP, Altomare I, Tulsky J, Ubel P, Schrag D, Nicolla J, Abernethy AP, Peppercorn J, Zafar SY. Patient-oncologist cost communication, financial distress, and medication adherence. J Oncol Pract. 2014 May;10(3):162–167.

Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

May 2014

Volume

10

Issue

3

Start / End Page

162 / 167

Location

United States

Related Subject Headings

  • Stress, Psychological
  • Physician-Patient Relations
  • Oncology & Carcinogenesis
  • Neoplasms
  • Medication Adherence
  • Male
  • Humans
  • Female
  • Disclosure
  • Cross-Sectional Studies