Predictors of Financial Toxicity Trajectories in Patients With Pancreatic Cancer: A Latent Class Growth Analysis

Abstract

Importance

Pancreatic cancer patients face varying medical expenses at different stages of treatment, resulting in dynamic changes in their financial toxicity. Longitudinal data collection is necessary to characterize the trajectory of these financial toxicity changes.

Objective

To Explore Potential Trajectories and Influencing Factors of Financial Toxicity among Pancreatic Cancer Patients.

Design

This was a prospective observational research study performed according to STROBE Checklist.

Setting and Participants

From August 2022 to August 2023, we conducted inpatient data collection from pancreatic cancer patients in three hospitals in Jiangsu Province.

Main Outcomes and Measures.

The COST scale was employed to investigate financial toxicity at four time points: upon admission (T0), at discharge (T1), 3 months post-discharge (T2), and 6 months post-discharge (T3). A latent growth model was utilized to classify the trajectories of financial toxicity and explore its influencing factors.

Results

The identification of financial toxicity trajectories among pancreatic cancer patients revealed three potential categories: a high-risk-financial toxicity stable group (19.69%), a moderate-risk-financial toxicity stable group (56.37%), and a low-risk-financial toxicity stable group (23.94%). Logistic regression analysis showed that, compared to the low-risk-financial toxicity stable group, the primary influencing factors for the high-risk-financial toxicity stable group were self-efficacy and total out-of-pocket medical expenses. In contrast to the low-risk-financial toxicity stable group, the moderate-risk-financial toxicity stable group was influenced by self-efficacy and total monthly household income. When comparing the moderate-risk-financial toxicity stable group to the high-risk-financial toxicity stable group, factors such as ACCI, employment status, total out-of-pocket medical expenses, and distance to healthcare facilities emerged as significant.

Conclusions and Relevance

The financial toxicity among pancreatic cancer patients has been categorized into three distinct trajectory patterns, each exhibiting significant population heterogeneity. It is imperative that we acknowledge the profound impact of financial toxicity on pancreatic cancer patients and strengthen relevant preventive and control measures to enhance their quality of life and therapeutic outcomes.