{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T15:10:37Z","timestamp":1788793837441,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Amyotrophic lateral sclerosis (ALS) is associated with substantial financial burden. How financial concerns are documented or addressed in ALS multidisciplinary clinics (MDC) is unclear. We aimed to characterize financial concerns among people living with ALS (pALS) and how they are identified and documented by multidisciplinary clinic staff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective electronic medical record (EMR) review for people living with ALS (pALS) attending at least two visits at the MDC, identifying documentation of financial concerns across all MDC notes throughout 2024. Semi\u2010structured interviews with MDC staff explored experiences with financial concern discussions and documentation. Rapid qualitative analysis was used to analyze interview content.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 67 pALS with at least 2 MDC visits, 45 (67.2%) had \u2265\u20091 documented financial concerns. Financial concerns were most documented in neurology physician notes and portal messages (both 77.8%) and included insurance denials, medication costs, disability\/Medicare navigation, caregiving expenses, and home modifications. Social work and patient portal notes provided greater detail than other staff notes. Staff interviews highlighted insurance and equipment costs as frequent financial concerns. Four qualitative themes emerged: insurance challenges and reliance on non\u2010insurance resources, financial barriers limiting care and quality of life, limited proactive conversations\/documentation, and the central role of social work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Financial concerns are common among pALS but are inconsistently discussed and documented in the EMR, often arising through asynchronous communication or social work. Integrating financial screening and promoting proactive multidisciplinary documentation may improve identification of financial concerns and support more equitable, person\u2010centered ALS care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70364","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:54:58Z","timestamp":1785290098000},"page":"1270-1274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Capturing Financial Burden Concerns in an\n                    <scp>ALS<\/scp>\n                    Multidisciplinary Clinic"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3428-3064","authenticated-orcid":false,"given":"Nikhita","family":"Pathapati","sequence":"first","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4426-8146","authenticated-orcid":false,"given":"Minh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaden","family":"Ju","sequence":"additional","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahita","family":"Maddukuri","sequence":"additional","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kiehl","sequence":"additional","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Kvale","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics &amp; Palliative Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0084-5308","authenticated-orcid":false,"given":"Aaron P.","family":"Thrift","sequence":"additional","affiliation":[{"name":"Section of Epidemiology and Population Sciences, Department of Medicine Baylor College of Medicine  Houston Texas USA"},{"name":"Dan L Duncan Comprehensive Cancer Center Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5666-5560","authenticated-orcid":false,"given":"Sarah","family":"Berth","sequence":"additional","affiliation":[{"name":"Department of Neurology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9596-9591","authenticated-orcid":false,"given":"Astrid","family":"Grouls","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Geriatrics &amp; Palliative Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2011.000418"},{"issue":"2","key":"e_1_2_11_3_1","first-page":"80","article-title":"Financial Toxicity, Part I: A New Name for a Growing Problem","volume":"27","author":"Zafar S. Y.","year":"2013","journal-title":"Oncology"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.6620"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.12.003"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibab091"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/OP.20.00907"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05507-9"},{"issue":"2","key":"e_1_2_11_9_1","first-page":"137","article-title":"Financial Toxicity Among People With Metastatic Cancer: Findings From the Cancer Experience Registry","volume":"32","author":"Mollica M. A.","year":"2024","journal-title":"Support Care Cancer"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213982"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2025.1633445"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41687-024-00834-5"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/11786329211057352"},{"key":"e_1_2_11_14_1","volume-title":"MDA Clinical & Scientific Conference 2020","author":"Millard J.","year":"2020"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/21678421.2017.1363242"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23942"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/21678421.2014.951946"},{"issue":"15","key":"e_1_2_11_18_1","first-page":"S336","article-title":"Economic Implications: Direct and Indirect Costs of ALS Therapy","volume":"24","author":"Santaniello B.","year":"2018","journal-title":"American Journal of Managed Care"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.022855"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-019-0948-1"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-024-09296-3"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9269"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.7306"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2025.09.2708"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2004.30249.x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1189-1"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.70364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mus.70364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.70364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:42:44Z","timestamp":1788792164000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.70364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":25,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/mus.70364"],"URL":"https:\/\/doi.org\/10.1002\/mus.70364","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}