Pilot study of an online app to reduce cancer patients' financial burden.

Health Services Research and Quality of Care
Session Type and Session Title: 
This abstract will not be presented at the 2016 ASCO Annual Meeting but has been published in conjunction with the meeting.
Abstract Number: 


J Clin Oncol 34, 2016 (suppl; abstr e18271)
Yousuf Zafar, Ian Manners, Jonathan Nicolla, Andrew Friedman, Greg P. Samsa, Kathryn Pollak; Duke University Medical Center, Durham, NC; Vivor, Chicago, IL; Duke Cancer Institute, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC

Abstract Disclosures


Background: PAPNavigator is a web-based app designed to reduce out-of-pocket treatment costs by connecting patients to financial assistance programs specific to their treatment, insurance, and financial situation. Providing cancer patients direct access to online financial navigation might assist more patients in financial need. It was designed to be used by oncology financial counselors and has not been tested in a patient population. Methods: This was a pilot study of PAPNavigator to determine patient-reported usability and preliminary effectiveness. Eligible cancer patients were receiving anti-cancer treatment and had out-of-pocket treatment costs. Patients interacted with PAPNavigator, inputted personal and financial data, and reviewed personalized financial resource results. Usability was assessed via the validated System Usability Scale (SUS). Domains assessed included ease of learning, efficiency, perceived user burden, utility, and satisfaction. Effectiveness was assessed by two measures (responses on 1-5 Likert scale): “PAPNavigator improved my knowledge about financial aspects of cancer care and what can be done about it,” and, “Using this website was helpful with my financial concerns” (for both items, 1 = strongly disagree, 5 = strongly agree). Results: 19 of 20 patients completed pilot testing (95%, 1 withdrew due to illness). 53% of patients were male, 26% were non-white, 79% had greater than high school education, and 21% were employed full- or part-time. Median annual household income was $77,500. 47% had Medicare, Medicare plus supplemental, Medicaid, or Medicare plus Medicaid. The median SUS score was 75 out of 100 (with > 68 considered above average). In response to the statements, “PAPNavigator improved my knowledge about financial aspects of cancer care and what can be done about it,” and, “Using this website was helpful with my financial concerns,” the median score for each was 4. Conclusions: PAPNavigator was considered highly usable and feasible. Even in a cohort with higher than average income, these results suggest PAPNavigator’s preliminary effectiveness in improving knowledge about financial aspects of cancer care and potential interventions to reduce cost.