Availability and accessibility of services to address financial toxicity described by Australian lung cancer patients and healthcare professionals

Holly Chung; Amelia Hyatt; Suzanne Kosmider; Kate Webber; Meinir Krishnasamy

doi:10.1007/s00520-023-08019-4

Availability and accessibility of services to address financial toxicity described by Australian lung cancer patients and healthcare professionals

Support Care Cancer. 2023 Sep 2;31(9):554. doi: 10.1007/s00520-023-08019-4.

Authors

Holly Chung^{1

2}, Amelia Hyatt^{2

3

4}, Suzanne Kosmider⁵, Kate Webber^{6

7}, Meinir Krishnasamy^{8

9

10

11}

Affiliations

¹ Academic Nursing Unit, Peter MacCallum Cancer Centre, 305 Grattan Street Parkville, Melbourne, Victoria, 3000, Australia.
² Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street Parkville, Melbourne, Victoria, 3000, Australia.
³ Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, 3010, Australia.
⁴ Department of Nursing, University of Melbourne, Melbourne, Victoria, 3010, Australia.
⁵ Cancer Services, Sunshine Hospital, Western Health, St Albans, Victoria, 3021, Australia.
⁶ Oncology Department, Monash Health, Clayton, Victoria, 3168, Australia.
⁷ School of Clinical Sciences, Monash University, Clayton, Victoria, 3800, Australia.
⁸ Academic Nursing Unit, Peter MacCallum Cancer Centre, 305 Grattan Street Parkville, Melbourne, Victoria, 3000, Australia. meinir.krishnasamy@petermac.org.
⁹ Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, 3010, Australia. meinir.krishnasamy@petermac.org.
¹⁰ Department of Nursing, University of Melbourne, Melbourne, Victoria, 3010, Australia. meinir.krishnasamy@petermac.org.
¹¹ Victorian Comprehensive Cancer Centre Alliance, Melbourne, Victoria, 3000, Australia. meinir.krishnasamy@petermac.org.

Abstract

Purpose: Although the financial burden and impact of a cancer diagnosis has been widely described in international literature, less understood is the availability and accessibility of services to ameliorate this need. This study reports the experiences of Australian lung cancer patients and health professionals delivering care, regarding factors that exacerbate and mitigate financial stress, and availability and accessibility of services to support people following a cancer diagnosis.

Methods: Qualitative semi-structured interviews with twenty-three lung cancer patients attending two metropolitan tertiary health services and eleven health professionals delivering care were undertaken during July-August 2021.

Results: Neither health service systematically screened for financial toxicity nor routinely provided information regarding potential financial impacts during consultations. Patients experienced lengthy delays in accessing welfare supports, provoking financial stress and worry. Health professionals reported limited resources and referral services to support patients with financial need; this was especially problematic for patients with lung cancer. They described its psychological impact on patients and their family members or carers and warned of its impact on ability to adhere to treatment.

Conclusion: Available and accessibility of services addressing financial toxicity in Australian lung cancer patients is inadequate. Although financial stress is a common, distressing problem, health professionals feel hampered in their ability to help due to limited service availability. Left unaddressed, financial toxicity can impact treatment adherence, directly influencing health outcomes, and increase risk of poverty, amplifying social inequities. Findings highlight opportunity for actionable interventions like financial consent and routine screening and discussion of financial toxicity across care pathways.

Keywords: Cancer supportive care; Financial toxicity; Lung cancer; Oncology; Patient experience; Qualitative.

MeSH terms

Australia
Financial Stress*
Health Personnel
Humans
Lung Neoplasms* / therapy
Treatment Adherence and Compliance