1114 - Mitigating Financial Hardships for Cancer Patients: The Effect of a Patient Support Registry on Patient Adherence to Radiotherapy

Purpose/Objective(s): Financial hardship may limit treatment adherence for cancer patients and caregivers, compromising clinical outcomes. To promote health equity, a patient support registry was established in January 2023 to allow patients and caregivers to request assistance with non-clinical needs. This study evaluates the impact of a single institution’s support registry on radiotherapy adherence.

Materials/Methods: All patients undergoing radiotherapy from 01/2023 to 11/2025 were included. Patients receiving any social work-assisted housing accommodation or transportation services were classified as service recipients. Treatment cancellations were evaluated at the appointment level. Generalized linear mixed modeling (GLMM) was performed to examine changes in treatment cancellations as a function of time (quarter of the year), registry participation (registry participant [RP] vs. non-participant [NP]), and interaction between time and registry participation. Stratified GLMMs within pre-defined subgroups were performed: age (<21, 21-65, >65), gender (female, male), disease site, insurance payer (Medicare, Medicaid, or commercial), total number of treatments (<6, 6-20, 21-30, >30), and utilization of accommodation or transportation services.

Results: Our cohort included 3,435 patients with an overall cancellation rate of 7.5%. The majority were male (55.5%), 21-65 years old (50.1%), and without utilization of accommodation (97.2%) or transportation (89.4%) services. In the overall cohort, there were no statistically significant changes in treatment cancellation rates over time, no main effect of registry participation, and no significant interaction between time and registry participation (all p>0.5). However, descriptive patterns suggested modest divergence over time, with cancellation rates decreasing among RP while remaining relatively stable among NP. In stratified analyses, among patients with Medicaid or transportation services at the initial quarter, the odds of cancellation were 76% (p=0.015) and 89% (p<0.001) lower, respectively, among RP compared to NP; however, per quarter, the odds of cancellation increased by 17% (p=0.018) and 28% (p=0.002), respectively, among RP relative to NP. There was no statistically significant interaction between time and registry participation by age group, gender, disease site, or total number of treatments, except among patients receiving 6-20 treatments (p=0.014).

Conclusion: Although overall cancellation trends did not differ between RP and NP, subgroup analyses demonstrated lower odds of cancellation among RP with Medicaid or needing transportation services at the initial quarter, but the odds of cancellation among RP increased for every quarter that passed. This shows that while the RP started at lower odds, the gap between RP and NP diminished over time, suggesting certain patients may derive greater benefit from this intervention. Further research is needed to identify strategies to improve care adherence.