Are Needs Assessments Cost Effective in Reducing Distress Among Patients With Cancer? A Randomized Controlled Trial Using the Distress Thermometer and Problem List

Hollingworth, William; Metcalfe, Chris; Mancero, Susana; Harris, Susan; Campbell, Rona; Biddle, Lucy; McKell-Redwood, Denise; Brennan, James

doi:10.1200/jco.2012.48.3040

Cited by 108 publications

(121 citation statements)

References 31 publications

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“…The study revealed from the interviews with the responsible clinical specialists that there was a lack of resources for the implementation of DT as a uniform assessment tool in the oncology departments, a finding which echoes previous studies looking at the extent to which DT as a tool is able to pinpoint the rehabilitation needs of cancer patients [25]. The interview findings illuminated that within all departments there was limited knowledge and a limited number of referrals to the district rehabilitation programs.…”

Section: Dt Not Integrated In From Patients' Treatment Protocolsupporting

confidence: 56%

Assessment of rehabilitation needs in colorectal cancer treatment: Results from a mixed audit and qualitative study in Denmark

et al. 2016

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Background Systematic assessments of cancer patients' rehabilitation needs are a prerequisite for devising appropriate survivorship programs. Little is known about the fit between needs assessment outlined in national rehabilitation policies and clinical practice. This study aimed to explore clinical practices related to identification and documentation of rehabilitation needs among patients with colorectal cancer at Danish hospitals. Material and methods A retrospective clinical audit was conducted utilizing data from patient files randomly selected at surgical and oncology hospital departments treating colorectal cancer patients. Forty patients were included, 10 from each department. Semi-structured interviews were carried out among clinical nurse specialists. Audit data was analyzed using descriptive statistics, qualitative data using thematic analysis. Results Documentation of physical, psychological and social rehabilitation needs initially and at end of treatment was evident in 10% (n ¼ 2) of surgical patient trajectories and 35% (n ¼ 7) of oncology trajectories. Physical rehabilitation needs were documented among 90% (n ¼ 36) of all patients. Referral to municipal rehabilitation services was documented among 5% (n ¼ 2) of all patients. Assessments at surgical departments were shaped by the inherent continuous assessment of rehabilitation needs within standardized fast-track colorectal cancer surgery. In contrast, the implementation of locally developed assessment tools inspired by the distress thermometer (DT) in oncology departments was challenged by a lack of competencies and funding, impeding integration of data into patient files. Conclusion Consensus must be reached on how to ensure more systematic, comprehensive assessments of rehabilitation needs throughout clinical cancer care. Fast-track surgery ensures systematic documentation of physical needs, but the lack of inclusion of data collected by the DT in oncological departments questions the efficacy of assessment tools and points to a need for distinguishing between surgical and oncological settings in national rehabilitation policies.

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Section: Dt Not Integrated In From Patients' Treatment Protocolsupporting

confidence: 56%

Assessment of rehabilitation needs in colorectal cancer treatment: Results from a mixed audit and qualitative study in Denmark

et al. 2016

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“…Randomized trials have found that screening alone does not improve psychological distress in patients with cancer and it has been concluded that screening is not a cost-effective intervention unless it is linked to an appropriate treatment programme (Hollingworth et al, 2013;Meijer et al, 2011). Our own clinical trials found a poor outcome for patients who were diagnosed with major depression by a screening programme and then allocated to usual care even though the patient, oncologist and primary care doctor were informed of the diagnosis (see below).…”

Section: Screening Alonementioning

confidence: 95%

“…However, there remains a lack of strong randomized trial evidence for the effi cacy of screening alone, and a growing realization that screening should only be undertaken if it is linked to a treatment programme (Hollingworth et al, 2013;Kroenke, 2001;Meijer et al, 2011). The main rationale for screening is therefore to overcome the failure of medical services to identify depressed patients so that they can be offered appropriate treatment.…”

Section: The Rationale For Screeningmentioning

confidence: 96%

Integrated management of major depression for people with cancer

Walker¹,

Sharpe²

2014

International Review of Psychiatry

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Major depression is an important complication of cancer. However, it is frequently inadequately treated. There are challenges both in identifying which cancer patients are depressed, and in ensuring that these patients receive effective treatment for their depression. Integration of depression management into cancer care has been advocated as a way to address these challenges. Such integrated approaches must include both the systematic identification of cases and the delivery of treatment. We describe here a system of depression care that includes both a screening programme to identify patients with depression and a linked treatment programme, based on the collaborative care model, called 'Depression Care for People with Cancer' (DCPC). The system of care was designed to be fully integrated with specialist cancer services and has been robustly evaluated in randomized trials. We describe how the system operates and explain why it is designed as it is. We also summarize the evidence for its effectiveness and cost-effectiveness and discuss its implementation in routine clinical practice.

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“…Some patients may not consider psychological counseling and some may avoid it due to perceived stigmas [84]. The development of efficient screening techniques will be necessary to rapidly assess patient needs and referral [85,86]. However, we would argue that all patients require psychological evaluation and support, not just those with emergent distress [70].…”

Section: The Psychoeducation Gapmentioning

confidence: 96%

Patient-Centered care in Cancer Treatment Programs: The Future of Integrative Oncology Through Psychoeducation

et al. 2014

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The reciprocal relationship between the mind and body has been a neglected process for improving the psychosocial care of cancer patients. Emotions form an important link between the mind and body. They play a fundamental role in the cognitive functions of decision-making and symptom control. Recognizing this relationship is important for integrative oncology. We define psychoeducation as the teaching of self-evaluation and self-regulation of the mind-body process. A gap exists between research evidence and implementation into clinical practice. The patients' search for self-empowerment through the pursuit of complementary therapies may be a surrogate for inadequate psychoeducation. Integrative oncology programs should implement psychoeducation that helps patients to improve both emotional and cognitive intelligence, enabling them to better negotiate cancer treatment systems.

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Are Needs Assessments Cost Effective in Reducing Distress Among Patients With Cancer? A Randomized Controlled Trial Using the Distress Thermometer and Problem List

Cited by 108 publications

References 31 publications

Assessment of rehabilitation needs in colorectal cancer treatment: Results from a mixed audit and qualitative study in Denmark

Assessment of rehabilitation needs in colorectal cancer treatment: Results from a mixed audit and qualitative study in Denmark

Integrated management of major depression for people with cancer

Patient-Centered care in Cancer Treatment Programs: The Future of Integrative Oncology Through Psychoeducation

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