August 5, 2021

Digital tool to reduce financial toxicity for patients with cancer wins national recognition from Association of Community Cancer Centers

The Association of Community Cancer Centers has named the Wayne State University School of Medicine and Barbara Ann Karmanos Cancer Institute one of seven recipients of its annual Innovator Award.

The award recognizes the work of Assistant Professor of Oncology Lauren Hamel, Ph.D., who on Oct. 21 will present “The Disco App: A Patient-Focused Tool to Reduce Financial Toxicity” at the ACCC’s 38th National Oncology Conference in Austin, Texas.

Lauren Hamel, Ph.D.

The DISCO (DIScussions of COst) app educates patients with cancer about potential treatment-related costs and generates tailored questions to prompt cost-related conversations with providers. In a pilot study, the app significantly improved patients’ self-efficacy for managing treatment costs and interacting with providers while decreasing cost-related distress. Most important, 100% of these video-recorded clinic visits included a cost discussion on topics ranging from patient co-pays to transportation.

Financial toxicity is a pervasive problem affecting a growing number of patients with cancer.

“We see the negative influence of financial toxicity across patient race, gender, socio-economic position, age and insurance type. Thus, it’s important for all patients to be aware of financial toxicity, even those who have never experienced financial hardship due to health concerns before,” Dr. Hamel said. “It’s equally important for patients to be armed with cost-focused questions tailored to their individual situation that they can ask their clinicians. It is that critical education and those tailored questions that the DISCO App provides to its patient users.”

The app team designed and tested the tool with diverse patient stakeholders, because patients who are racial/ethnic minorities, patients who are younger and patients with lower socio-economic positions are at greater risk for financial toxicity, she added.

She has presented the DISCO App and the findings from a clinical-based pilot trial to numerous groups, including presentations at the American Society of Clinical Oncology’s Quality Care Symposium, presentations to professional organizations and local presentations to WSU/KCI’s Cancer Action Councils, whose members provided critical input and feedback at all stages of the DISCO App’s development.

They now have two randomized clinic-based trials to test the DISCO App’s short- and long-term effectiveness in a diverse patient population with solid and liquid tumors.

“Widespread distribution is a few years away as we collect and analyze the DISCO App’s influence on patient outcomes, including their communication with their clinicians, their experience of financial toxicity and their treatment adherence,” Dr. Hamel said. “However, because it is app-based it will be relatively easy to disseminate statewide and, hopefully, nationally too.”

The DISCO App and research program surrounding it is a team effort, she added.

“I’m honored that my team and my work are being recognized in this way. It’s certainly rewarding after all of the time and effort we’ve put into this program of research, but it is also motivating to keep this work going and continue to develop the DISCO App and related projects,” Dr. Hamel said. “Professor of Oncology and Population Science Susan Eggly, Ph.D., of the WSU School of Medicine, is my close collaborator and mentor. Her expertise on patient-physician communication, treatment disparities and clinic-based interventions provided the foundation for me to design, build and test the DISCO App.”

The research team also includes WSU’s Associate Professor of Oncology Felicity Harper, Ph.D.; Professor of Oncology Ann Schwartz, Ph.D.; Professor of Oncology Elisabeth Heath, M.D.; and research assistants Lorna Mabunda and Roger Soulliere. She also collaborates closely with Dana-Farber Cancer Institute of Boston medical oncologist David Dougherty, M.D.

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