Responding to the quality imperative to embed mental health care into ambulatory oncology

Penedo, Frank J.; Cella, David

doi:10.1002/cncr.30402

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…A growing body of literature has documented the needs of oncology patients, providing evidence that psychological and physical concerns are both prevalent and persistent. 3 About 32% of patients with cancer have been shown to meet criteria for mental health conditions. 2 4 In a meta-analysis of 70 studies with over 10 000 oncology patients in ambulatory settings, 16.3%, 10.3% and 19.4% met Diagnostic and Statistical Manual of Mental Disorders (DSM 5) criteria for major depression, adjustment and anxiety disorders, respectively; 38.2% met criteria for any psychological diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer centre

et al. 2022

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Introduction Cancer symptom monitoring and management interventions can address concerns that may otherwise go undertreated. However, such programmes and their evaluations remain largely limited to trials versus healthcare systemwide applications. We previously developed and piloted an electronic patient-reported symptom and need assessment (‘cPRO’ for cancer patient-reported outcomes) within the electronic health record (EHR). This study will expand cPRO implementation to medical oncology clinics across a large healthcare system. We will conduct a formal evaluation via a stepped wedge trial with a type 2 hybrid effectiveness-implementation design. Methods and analysis Aim 1 comprises a mixed method evaluation of cPRO implementation. Adult outpatients will complete cPRO assessments (pain, fatigue, physical function, depression, anxiety and supportive care needs) before medical oncology visits. Results are available in the EHR; severe symptoms and endorsed needs trigger clinician notifications. We will track implementation strategies using the Longitudinal Implementation Strategy Tracking System. Aim 2 will evaluate cPRO’s impact on patient and system outcomes over 12 months via (a) a quality improvement study (n=4000 cases) and (b) a human subjects substudy (n=1000 patients). Aim 2a will evaluate EHR-documented healthcare usage and patient satisfaction. In aim 2b, participating patients will complete patient-reported healthcare utilisation and quality, symptoms and health-related quality of life measures at baseline, 6 and 12 months. We will analyse data using generalised linear mixed models and estimate individual trajectories of patient-reported symptom scores at baseline, 6 and 12 months. Using growth mixture modelling, we will characterise the overall trajectories of each symptom. Aim 3 will identify cPRO implementation facilitators and barriers via mixed methods research gathering feedback from stakeholders. Patients (n=50) will participate in focus groups or interviews. Clinicians and administrators (n=40) will complete surveys to evaluate implementation. We will graphically depict longitudinal implementation survey results and code qualitative data using directed content analysis. Ethics and dissemination This study was approved by the Northwestern University Institutional Review Board (STU00207807). Findings will be disseminated via local and conference presentations and peer-reviewed journals. Trial registration number NCT04014751; ClinicalTrials.gov.

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Section: Introductionmentioning

confidence: 99%

“…A growing body of literature has documented the needs of oncology patients, providing evidence that psychological and physical concerns are both prevalent and persistent 3. About 32% of patients with cancer have been shown to meet criteria for mental health conditions 2 4.…”

Section: Introductionmentioning

confidence: 99%

Protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer centre

et al. 2022

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“…The screening of depression is now becoming a significant aspect of cancer care. 6 For example, the National Comprehensive Cancer Network and the Institute of Medicine have created guidelines and recommendations for routine screening of distress (including depression symptoms) as a quality standard in oncology practice. 7 It is recommended that those responsible for the care of patients with cancer screen for depression and provide further assessment for patients that screen positive for depression; and the process should identify patients that could benefit from additional support.…”

Section: Introductionmentioning

confidence: 99%

Technology-assisted depression screening tools for patients with cancer: a systematic review protocol

et al. 2021

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IntroductionAmong patients with cancer, depression is still under-detected. The use of technology-assisted screening tools is rising; however, little is known about the uptake of these devices as depression screening tools among patients with cancer.Methods and analysisA systematic review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The review is registered with PROSPERO and any adjustments to the protocol will be traced. The aims of this systematic review are to (1) identify the most common and feasible depression screening information technology (IT) delivery models among patients with cancer, (2) identify the most common depression screening instrument used in IT devices and (3) describe the published technology-assisted depression screening tools for patients with cancer. PubMed, EBSCOhost and Google Scholar databases will be used. PICO (Patient/Population, Intervention, Comparison, Outcomes) guidelines will inform the inclusion criteria. Two researchers will independently review titles and abstracts, followed by full article review and data extraction. In the case of a disagreement, a third reviewer will make the final decision. Title/abstract screening will be conducted using a screening tool prepared by the researchers. Articles will be included for review if: (1) the study includes patients with cancer, cancer survivors and/or patients on remission, (2) depression is screened using technology and (3) technology-assisted depression screening effectiveness, efficacy, feasibility and/or acceptance is addressed. The quality of the articles will be assessed using the Methodological Index For Non-Randomised Studies (MINORS, maximum score 24) through independent coding of reviewers.Ethics and disseminationThis research is exempt from ethics approval given that this is a protocol for a systematic review, which uses published data. Findings from this review will be disseminated through peer-reviewed publications and scientific conferences.Systematic review registrationPROSPERO registration number CRD42019121048.

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“…1-4,8,9 Others note that they lack both access to adequate brief measures and time to conduct lengthy assessment in busy clinical environments. 10,11 Empirical data on the impact of the implementation of routine suicide assessment programs within the oncology care outpatient setting remain lacking, including data detailing both the barriers and facilitators for optimal implementation.…”

mentioning

confidence: 99%

Addressing Suicidal Ideation in Patients With Cancer: Recommendations for the Oncology Clinician on How to Optimize Routine Screening in the Outpatient Setting

Hlubocky

Dokucu

2023

JCO Oncology Practice

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Responding to the quality imperative to embed mental health care into ambulatory oncology

Cited by 5 publications

References 20 publications

Protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer centre

Protocol for a type 2 hybrid effectiveness-implementation study expanding, implementing and evaluating electronic health record-integrated patient-reported symptom monitoring in a multisite cancer centre

Technology-assisted depression screening tools for patients with cancer: a systematic review protocol

Addressing Suicidal Ideation in Patients With Cancer: Recommendations for the Oncology Clinician on How to Optimize Routine Screening in the Outpatient Setting

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