Implementation of a medical oncology fellow-initiated financial toxicity screening program in outpatient medical oncology clinics

Abstract

Introduction The National Cancer Institute defines financial toxicity as “problems a patient has related to costs of cancer care.” Financial toxicity is a critical problem in cancer treatment and one that remains conventionally outside of clinical discussion and treatment decision-making. Methods This is a feasibility pilot study of the implementation of a medical oncology fellow-led financial toxicity screening intervention program at the Helen Diller Family Comprehensive Cancer Center (HDFCCC) at the University of California San Francisco. Fellows were asked to conduct and document financial toxicity screening of patients seen in medical oncology outpatient clinics from August 2017 to March 2018 in the electronic medical record. Results At baseline, no fellows documented financial toxicity screening. Screening rates peaked at 49%, however at the end of the intervention the screening rate decreased to 11% among participants. Conclusions The results of the pilot feasibility study revealed that a fellow-led financial toxicity screening program in medical oncology clinics rendered low adherence to patient screening. Future research will need to develop mechanisms for identifying patients who may experience high levels of financial distress in medical oncology practice.