Communication of costs and financial burdens between cancer patients and healthcare providers: a qualitative systematic review and meta-synthesis

Abstract

Objectives: The aim of this study was to synthesize qualitative research regarding communication of costs and financial burdens between patients and healthcare providers to provide evidence for the subsequent development of intervention programs.

Methods: Studies published prior to 11 February 2023 were collected from electronic databases, including PubMed/MEDLINE, MEDLINE (Ovid), Web of Science, EMBASE (Ovid), CINAHL (EBSCO), and ProQuest. A checklist for qualitative research drawn from the Joanna Briggs Institute Reviewer's Manual was applied to assess the quality of the included studies. Meta-aggregation was performed to synthesize the findings of the included studies.

Results: Four synthesized findings were derived from 15 studies: cost communication offered more benefits than drawbacks, and most patients were willing to engage in cost communication; cost communication has been implemented in clinical practice but continued to face shortcomings and barriers; an expected cost communication should take into account timing, location, personnel, personality, and content; healthcare providers required education, information, tools, standardized processes, and policy and organizational support to increase their ability to deliver cost communication.

Conclusions: Cost communication can help optimize decision-making and reduce the risk of financial difficulties, as has been widely recognized by patients and healthcare providers. However, a complete clinical practice plan to facilitate cost communication has not yet been created.

Keywords: Cancer; Cost communication; Financial burdens; Financial toxicity; Meta-synthesis; Systematic review.