Following patient pathways to psycho‐oncological treatment: Identification of treatment needs by clinical staff and electronic screening

Abstract

ObjectiveIn this retrospective investigation of patient pathways to psycho‐oncological treatment (POT), we compared the number of POT referrals before and after implementation of electronic screening for POT needs and investigated psychosocial predictors for POT wish at a nuclear medicine department.MethodsWe extracted medical chart information about number of referrals and extent of follow‐up contacts. During standard referral (November 2014 to October 2015), POT needs were identified by clinical staff only. In the screening‐assisted referral period (November 2015 to October 2016), identification was supported by electronic screening for POT needs. Psychosocial predictors for POT wish were examined using logistic regression.ResultsWe analysed data from 487 patients during standard referral (mean age 56.4 years; 60.2% female, 88.7% thyroid carcinoma or neuroendocrine tumours) of which 28 patients (5.7%) were referred for POT. Of 502 patients in the screening‐assisted referral period (mean age 57.0 years; 55.8% female, 86.6% thyroid carcinoma or neuroendocrine tumours), 69 (13.7%) were referred for POT. Of these, 36 were identified by psycho‐oncological (PO) screening and 33 by clinical staff. After PO‐screening implementation, referrals increased by a factor of 2.4. The strongest predictor of POT wish was depressive mood (P < .001). During both referral periods, about 15% of patients visited the PO outpatient unit additionally to inpatient PO consultations.ConclusionsOur results provide evidence from a real‐life setting that PO screening can foster POT referrals, reduce barriers to express the POT wish, and hence help to meet psychosocial needs of this specific patient group. Differences between patients' needs, wish, and POT uptake should be further investigated.

Cancer patients’ wish for psychological support during outpatient radiation therapy

“…Firstly, screening for psychological distress by clinicians is unsatisfactory, resulting in an underestimation of patients’ distress levels and a lower number of referrals [ 4 , 17 ]. Routine distress screening can significantly increase the number of referrals to PO [ 18 ]: when actively offered during radiotherapy, 13–41% of the patients accepted referral [ 6 , 19 , 20 ]. Incorporation of such screening procedures into clinical routine to effectively identify distressed cancer patients to enable quick and adequate PO is recommended [ 21 , 22 ].…”

Please mind the gap—about equity and access to care in oncology

“…Although POT has been the standard of care in developed countries such as Austria and Germany (OnkoZert), identifying and measuring clinical distress by continuous screening tools could be challenging in countries with fewer resources. 24 …”

Patient-reported outcomes and psycho-oncological screening in hematology: a practical example of routine electronic monitoring

“…For the screening of psychooncological treatment needs at the Department of Hematology Innsbruck, the HSI is supplemented with five additional items on episodes of depressive mood or anxiety, previous psychological or psychiatric treatment, and patients' personal wish to talk to a psychooncologist. This results in a total of 12 items which has been shown to be feasible for screening purposes [44]. To keep response burden low, patients complete the HSI screening in 3-month intervals.…”