A consolidated screening tool for supportive oncology needs and distress.

Abstract

47 Background: The IOM 2013 Report recommends that supportive oncology care start at cancer diagnosis; the Commission on Cancer (CoC) Standard 3.2 requires distress screening and indicated action. Screening tools are not standardized across institutions and often address only a portion of patients’ supportive oncology needs. Methods: A collaborative of 100+ clinicians, funded by The Coleman Foundation, developed a patient-centric consolidated screening tool based on validated instruments (NCCN Distress, PHQ-4, PROMIS) and IOM and CoC. The screening tool was piloted at 6 practice-improvement cancer centers in the Chicago area (3 academic, 2 safety-net, 1 public). Patients, providers assessing patients’ screening results (assessors), and providers receiving referrals (providers) were surveyed after use of the screening tool. Descriptive statistics were used to assess effectiveness of the tool. Results: Responders included 175 patients, 81 assessors, and 26 referral providers (social workers, chaplains, subspecialists). The majority of patients (160/175, 91%) completed the screening in <10 minutes, across all patients the screening tool averaged 4 ½ minutes. Most assessors (59/77, 76%) spent <5 minutes reviewing screening results. Most patients, assessors, and providers reported the screening tool asked the “right questions”. Assessors reporting partial relevance of some screening questions for 34% (26/77) of patients, uncovered ≥ 1 relevant needs for 96% (25/26) of those patients (p = 0.002). Conclusions: Use of a consolidated supportive oncology screening tool across multiple institutions is feasible, identified unmet patient needs, and was beneficial for assessors and providers. As the tool is adopted by collaborating institutions, variability in supportive oncology screening practices may decline, thus improving patient care. The tool has implications for quality improvements and national dissemination. [Table: see text]

Meeting the guidelines: Implementing a distress screening intervention for veterans with cancer

“…An interdisciplinary group of healthcare clinicians across 35‐CSOC organizations adhered to recommendations 18 and combined measures to create the “Patient Screening Questions for Supportive Care” (Figure S2). This screening tool includes a compilation of validated measures that underwent appropriate utility testing and takes about 5–10 min to complete 19,20 . Measures included The NCCN distress management needs assessment problem list, patient‐reported outcomes measurement information system‐pain intensity, fatigue‐short form, physical function, and instrumental support subscales, The mini nutrition assessment short‐form, and Patient Health Questionnaire‐4.…”