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Physician-patient communication of costs and financial burden of cancer and its treatment: a systematic review of clinical guidelines.
Agarwal, Anupriya; Livingstone, Ann; Karikios, Deme J; Stockler, Martin R; Beale, Philip J; Morton, Rachael L.
Afiliação
  • Agarwal A; NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia. anupriya.agarwal@sydney.edu.au.
  • Livingstone A; Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia. anupriya.agarwal@sydney.edu.au.
  • Karikios DJ; NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
  • Stockler MR; NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, 2050, Australia.
  • Beale PJ; Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia.
  • Morton RL; Nepean Cancer Centre, Nepean Hospital, Kingswood, New South Wales, Australia.
BMC Cancer ; 21(1): 1036, 2021 Sep 16.
Article em En | MEDLINE | ID: mdl-34530765
BACKGROUND: Optimising the care of individuals with cancer without imposing significant financial burden related to their anticancer treatment is becoming increasingly difficult. The American Society of Clinical Oncology (ASCO) has recommended clinicians discuss costs of cancer care with patients to enhance shared decision-making. We sought information to guide oncologists' discussions with patients about these costs. METHODS: We searched Medline, EMBASE and clinical practice guideline databases from January 2009 to 1 June 2019 for recommendations about discussing the costs of care and financial burden. Guideline quality was assessed with the AGREE-II instrument. RESULTS: Twenty-seven guidelines met our eligibility criteria, including 16 from ASCO (59%). 21 of 27 (78%) guidelines included recommendations about discussion or consideration of treatment costs when prescribing, with information about actual costs in four (15%). Recognition of the risk of financial burden or financial toxicity was described in 81% (22/27) of guidelines. However, only nine guidelines (33%) included information about managing the financial burden. CONCLUSIONS: Current clinical practice guidelines have little information to guide physician-patient discussions about costs of anticancer treatment and management of financial burden. This limits patients' ability to control costs of treatment, and for the healthcare team to reduce the incidence and severity of financial burden. Current guidelines recommend clinician awareness of price variability and high costs of treatment. Clinicians are recommended to explore cost concerns and address financial worries, especially in high risk groups. Future guidelines should include advice on facilitating cost transparency discussions, with provision of cost information and resources.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Relações Médico-Paciente / Guias de Prática Clínica como Assunto / Efeitos Psicossociais da Doença / Comunicação / Oncologistas / Neoplasias Tipo de estudo: Diagnostic_studies / Guideline / Health_economic_evaluation / Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Relações Médico-Paciente / Guias de Prática Clínica como Assunto / Efeitos Psicossociais da Doença / Comunicação / Oncologistas / Neoplasias Tipo de estudo: Diagnostic_studies / Guideline / Health_economic_evaluation / Prognostic_studies / Qualitative_research / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Austrália