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  • DISCO: A Patient Intervention to Reduce the Financial Burden of Cancer

    Cancer Categories
    • Breast,Gastrointestinal (GI),Genitourinary (GU),Lung
    Karmanos Trial ID
    • 2020-117
    NCT ID
    • NCT04766190
    Age Group
    • Adult
    Scope
    • Local
    PhaseClick for Clinical Trial Phase DefinitionQuestions, please contact us
    • N/A
    Principal Investigator
    • Hamel, Lauren

    Objective:

    Aim 1: Using a RCT, determine the effectiveness of the Discussions of Cost App (DISCO App) on shortterm outcomes at three levels:
    • patient (treatment cost knowledge, self-efficacy for managing cost and physician interactions, and perceived financial toxicity [cost distress, material hardship]);
    • patient-oncologist interaction (patient active participation; frequency and quality of patient-initiated cost discussions with oncologists; oncologists’ patient-centered communication as observed in video recordings); and
    • healthcare utilization (social work/financial navigation referrals, social work/financial navigation referral uptake).
    • H1a: We hypothesize that the DISCO App will improve outcomes for all intervention patients, and
    • H1b: Black patients will experience greater improvement than White patients, lower-income patients will experience greater improvement than higher-income patients, and younger patients will experience greater improvement than older patients.

    Aim 2: Determine the effectiveness of the DISCO App on longer-term outcomes (financial toxicity, treatment adherence, and clinic appointment adherence). We will compare longer-term outcomes across arms.
    • H2a: We hypothesize that: patients receiving the DISCO App + booster will experience the greatest improvement in outcomes, followed by patients receiving the DISCO App, and last, usual care; and that
    • H2b: Black patients will experience greater improvement in outcomes than White patients.

    Aim 3: Test potential mediators and moderators of the relationship between the short-term and longerterm outcomes of the DISCO App.
    • H3: We hypothesize that the DISCO App will increase the frequency and quality of patient-initiated cost discussions, which will increase social work/financial navigation referrals, social work/financial navigation referral uptake, and patient self-efficacy for managing treatment cost, which in turn will reduce financial toxicity and improve adherence.
    • H4: We hypothesize that this relationship will be moderated by patient socio-demographic characteristics.
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