Perceived economic hardship and distress in acute myelogenous leukemia
Multiple studies have quantified the direct and indirect costs and related patient hardship and distress in general cancer care; however, little attention has been focused on a particular cancer with great potential for economic hardship, acute myeloid leukemia (AML). The purpose of this study was to explore the concept of perceived economic hardship and economic distress among a cohort of adult patients at least 6 months postdiagnosis of AML. Methods: A cross-sectional assessment of adult patients 6 months postdiagnosis of AML currently receiving outpatient treatment at a National Cancer Institute-designated cancer center was conducted. Three surveys were utilized to assess the patients' perceived financial toxicity: the Comprehensive Score for Financial Toxicity-Patient Reported Outcome Measure (COST-PROM), used to measure economic distress; the University of Pittsburgh School of Nursing Demographics Questionnaire; and the Measure of Economic Hardship used to assess a specific measure of economic hardship. Paper surveys were offered to eligible patients upon arrival for routine follow-up visits, and participants were asked to complete the survey in the waiting room prior to the clinician visit or in the treatment room while receiving treatment. Results: The survey was completed by 26 of 32 eligible patients. The sample was equally divided in gender and included a majority of participants who were insured and well educated. Patients with AML reported higher levels of economic hardship and distress compared with other cancers. Only age (not insurance or income) was correlated with economic hardship or distress. Race was correlated with inability to meet bills. Perceived economic hardship was significantly correlated with economic distress. Discussion: To help ensure optimal benefit from CML therapy, it is essential to develop and evaluate interventions that foster patient-clinician communication and referral for services related to both financial need and psychosocial distress. Conclusion: These results suggest that perceived economic hardship and subsequent distress are present among patients with AML. Both economic concern and distress appear to be unrelated to income or insurance
