Our findings suggest that female patients reported more distress, anxiety, and depression than male patients. Gender differences were related to problem-related distress but not to grade of neoplasm. We observed that, over the course of chemotherapy, the distress levels of patients with hematological cancer decrease over time.

The current study provides preliminary evidence that a multidisciplinary structured screening program utilizing validated measures and team meetings is associated with reduced impairment in patients' psychological well being. This program provided more opportunities for collaboration among providers with increased multidisciplinary meetings, enabled patients to more easily report problems, and ensured rapid access to relevant resources.

No abstract

BACKGROUND: The integration of a biopsychosocial screening (BPS) program has been proposed by international agencies to better identify and effectively manage unmet needs among patients with cancer. We sought to evaluate the effect of a BPS program on hospital admissions and length of stay (LOS) among a diverse sample of patients with cancer and receiving treatment in Brazil. METHODS: A retrospective analysis was performed from March 2020 to December 2021. Eligible patients were diagnosed with cancer and were receiving treatment at a private practice in Brazil. Clinical characteristics, participation in the BPS program, hospital admissions, reason, and LOS in hospital were evaluated. We compared the number of hospital admissions and LOS between groups (participation v no participation). T test and Chi-square test were used to test for differences between groups. RESULTS: A total of 1,014 patients were included in the analysis. Baseline clinical characteristics were well balanced between groups (n = 459 patients who participated and n = 555 patients who did not). The median age of patients was 63 years. Breast and hematological cancers were the most common types of cancer; 60% were diagnosed at an advanced disease stage. A smaller proportion of patients who participated in the BPS program were hospitalized compared with patients who did not participate (8% v 32%, P = .001). Patients who participated in the program also spent less days in the hospital compared with patients who did not participate in the program (M = 4.2 days v 9.8 days, P = .001). CONCLUSION: Engagement in a BPS program was associated with reduced hospital admissions and LOS. This study provides novel insight into the potential broader implications of BPS programs for clinical care systems. Future studies are needed to explore the mechanisms behind such associations.

e19504 Background: Cancer care still fails to address psychosocial problems, which can compromise the effectiveness of health care and thereby adversely affect cancer patients. The present retrospective study explores a routine of distress screening, followed by a multidisciplinary discussion, in order to devise strategies for intervention and treatment. Methods: Over two years, 328 patients from a private cancer center, located in Brasilia, the capital of Brazil, participated in a longitudinal study. They were evaluated three times over a 6-month period using the Distress Thermometer and the Hospital Anxiety and Depression Scale. The data of each evaluation were discussed between oncologist assistant and psychologist, establishing appropriate intervention. Descriptive statistics, Pearson’s correlation and a logistic regression were employed to analyze the data. Results: There was a prevalence of female patients (64%). They were between 18 - 86 years (M = 54.7, SD = 15.8). Gastrointestinal (28%), breast (23.8%) and hematologic cancer (22.6%) were the main diagnosis, being 29% with early disease stage and 59.1% with late stage. The distress level progressively decreased along the evaluations: first day (55.8%), middle (27%) and last day of chemotherapy (13.4%). The same decrease occurred in anxiety and depression scale. There was a significant association (p < .001) between distress vs. anxiety and distress vs. depression over phases of evaluation: first day (r = 0.8, t(328) = 21.6; r = 0.8, t(328) = 16.2; R2 = 0.85), middle (r = 0.8, t(285) = 18.4; r = 0.8, t(285) = 20.9; R2 = 0.86) and last day of chemotherapy (r = 0.8, t(261) = 14.7; r = 0.8, t(261) = 20.8; R2 = 0.82). The incidence of distress shows to be related to anxiety, depression, gender, emotional and physical problems. Conclusions: Preliminary results suggest that distress, anxiety and depression scores tends to reduce during the 6-months period of evaluation. This results support the multidisciplinary discussion in order to propose the best intervention and treatment tailored to each case, being more assertive. In our experience we note the importance of distress screening and the health team integration to understand patient's experiences and to improve cancer care.

Objective Emotional symptoms are frequently reported among patients with cancer. We evaluated the association between emotional symptoms and problem‐related distress in a sample of patients with cancer about to initiate chemotherapy within a private hospital in Brazil. Methods Patients were assessed before initiating chemotherapy, treatment mid‐point, and on the last day of treatment for anxiety and depression (Hospital Anxiety and Depression Scale [HADS]) and for problem‐related distress (Distress Thermometer Problem List). Problem‐related distress variable was computed as the sum of practical, physical, spiritual and familial problems. Mixed‐model analysis was applied to determine the association between HADS and problem‐related distress, adjusting for age and gender. Results A total of 655 consecutive patients were enrolled. There was a significant main effect of time (F = 8.99, p = 0.0001), showing that emotional symptoms improve over time. A significant main effect was observed for problem‐related distress (F = 371.56, p < 0.0001) revealing that patients with elevated problem‐related distress at baseline tend to have higher HADS across the three time points, compared to patients with lower problem‐related distress. There was an interaction effect between problem‐related distress and time (F = 85.22, p < 0.0001), suggesting that HADS scores decreased differently over time, depending on patients' initial level of problem‐related distress. Conclusion Overall, emotional symptoms, while decreasing over time, remained associated with problem‐related distress after chemotherapy in Brazil. The potential benefit of implementing a psychosocial intervention remains high throughout cancer treatment.

Background This study sought to determine the feasibility and acceptability of a remote geriatric assessment (GA) and implementation (GAIN) program in Brazil. The authors also explored the effect of this program on health‐related quality of life (HR‐QOL) outcomes 3 months after initiating treatment. Methods This is a longitudinal study enrolling older adults (65+ years), diagnosed with any type of solid tumor, scheduled to initiate chemotherapy in a networked Brazilian cancer center. The GA was performed through telehealth. We assessed the feasibility of the remote GA, acceptability to patients, and changes in patient‐centered outcomes (HR‐QOL, mood, function) from baseline to month 3. Linear mixed model analysis was done, adjusting for age, gender, race, income, and disease stage. Results Fifty‐six patients completed all intended assessments. Notably, the threshold of feasibility was 70% and there was 92% complete adherence. Average age was 76 years old (SD = 7.2). Most patients were female (57%), married (59%), and had a college degree (46%). The most common diagnoses were gastrointestinal (39%) and gynecological cancers (18%); most were diagnosed at an advance disease stage (77%). A total of 32 patients were referred to a remote appointment and 86% followed this recommendation(s). Significant improvement in Functional Assessment of Cancer Therapy ‐ General FACT‐G (mean difference, 6.04; p < .001), Geriatric Depression Scale (mean difference, −0.86; p = .008), and instrumental activities of daily living ratio (mean difference, 0.17; p < .001) were found. Conclusion Remote GAIN is feasible and acceptable to older adults with cancer receiving treatment in Brazil. The authors also found significant improvement in HR‐QOL outcomes over time. Notably, this GAIN program could guide early detection of chemotherapy toxicity and improving patient‐reported outcomes in low‐resource environments.

e20686 Background: Distress is present in every phase of cancer. This high prevalence of distress showed the necessity of acting strategies that may favor the reduction or elimination of possible psychological and psychiatric disturbances. Facing this reality, the National Comprehensive Cancer Network suggested Distress Management in 1997. Today the oncological units need not only acting strategies, but also methods of evaluation of assistance quality. Methods: This study main goal was to evaluate the assistance offered in a private cancer treatment center in Brazil, using the distress prevalence during all the phases of the treatment as a quality indicator. Patients (N = 169) of both genders (37.9% male and 62.1% female), with age between 17 and 86 years (median = 53), with 18 types of cancer, took a part in this investigation. The research was authorized by an ethics committee. The procedure of gathering data included the consent of patients and the application of the Distress Thermometer (DT). The evaluation was made in three distinct stages of chemotherapy: beginning, middle and end of treatment. The data were analyzed according to the criteria defined in literature and with the software SPSS 15.0. Results: In the first stage of the evaluation, the major part of the patients showed a significative level of distress (69.8%), which is similar to literature data - In this phase the patients live with pain, losses and incertitude in relation to the prognoses. During the treatment, there was a progressive reduction in the second (32.4%) and in the last phase of evaluation (14.3%). Such fall was due to: 1) the routine of monitoring distress, the identification of the nature of distress and the intervention; 2) integration of the health team in a interdisciplinary work. Conclusions: The significative reduction of distress during the treatment points out to a good quality of cancer care. During the research it was possible to identify improvements and to reconsider some attitudes and conducts. There was a non automatization in the assistance, making it more human, individual and specific for each necessity. This result suggests the importance of DT as a quality indicator of cancer care. No significant financial relationships to disclose.