Effects of an Interprofessional Communication Approach on Support Needs, Quality of Life, and Mood of Patients with Advanced Lung Cancer: A Randomized Trial

Abstract

Background. To address the support needs of newly diagnosed patients with lung cancer with limited prognosis, the Milestone Communication Approach (MCA) was developed and implemented. The main elements of the MCA are situation-specific conversations along the disease trajectory conducted by an interprofessional tandem of physician and nurse. The aim of the study was to evaluate the effects of MCA on addressing support needs, quality of life, and mood as compared with standard oncological care. Patients and Methods. A randomized trial was conducted with baseline assessment and follow-up assessments at 3, 6, and 9 months in outpatients with newly diagnosed lung cancer stage IV at a German thoracic oncology hospital. The primary outcome was the Health System and Information Needs subscale of the Short Form Supportive Care Needs Survey (SCNS-SF34-G) at 3-month follow-up.Secondary outcomes included the other subscales of the SCNS-SF34-G, the Schedule for the Evaluation of Individual Quality of Life, the Functional Assessment of Cancer Therapy lung module, the Patient Health Questionnaire for Depression and Anxiety, and the Distress Thermometer. Results. At baseline, 174 patients were randomized, of whom 102 patients (MCA: n = 52; standard care: n = 50) provided data at 3-month follow-up. Patients of the MCA group reported lower information needs at 3-month followup (mean AE SD, 33.4 AE 27.5; standard care, 43.1 AE 29.9; p = .033). No effects were found for secondary outcomes. Conclusion.MCA lowered patient-reported information needs but did not have other effects. MCA contributed to tailored communication because an adequate level of information and orientation set the basis for patient-centeredcare. The Oncologist 2021;26:1-15 Implications for Practice: By addressing relevant issues at predefined times, the Milestone Communication Approach provides individual patient-centered care facilitating the timely integration of palliative care for patients with a limited prognosis. The needs of patients with lung cancer must be assessed and addressed throughout the disease trajectory. Although specific topics may be relevant for all patients, such as information about the disease and associated health care, situations of individual patients and their families must be considered. Additionally, using the short form of the Supportive Care Needs Survey in clinical practice to identify patients' problems might support individually targeted communication and preference-sensitive care.

Interprofessional collaboration and patient-reported outcomes: a secondary data analysis based on large scale survey data

“…Here, the patients’ overall satisfaction did not differ between intervention and control group. In studies using other kinds of PRO measures the association between IPC and PROs in terms of quality of life, symptoms, anxiety, and depression remained unclear, as well [ 3 , 4 , 6 ]. With regard to the different effects of the above-named IPC components in our analysis, Carron et al [ 2 ] also came to the conclusion, that the effect of IPC was likely related to the specific IPC-type.…”

“…5 Center for Health Services Research, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany. 6 Faculty of Health Sciences Brandenburg, Potsdam, Germany. • support for research data, including large and complex data types • gold Open Access which fosters wider collaboration and increased citations maximum visibility for your research: over 100M website views per year…”

“…The overall evidence of the association of IPC with patients' outcomes remains uncertain. Whereas positive effects have been found with regard to clinical endpoints [3], patient-reported outcomes (PROs) are underrepresented in the literature and the little data available do not show a clear direction of relationships [2][3][4][5][6][7].…”

Communication with patients with limited prognosis—an integrative mixed-methods evaluation study

“…A milestone communication approach (MCA) to address communication needs has been developed, implemented, and evaluated using mixed methods. Some MCA results were analyzed separately and have been published [19][20][21]. The results of the pragmatic randomized controlled trial showed significantly fewer health system and information needs (SCNS-34-SF) in the MCA group compared to the control group (MCA: M = 33.4, SD = 27.5; standard care: M = 43.1, SD = 29.9, p = 0.033; effect size: Cohen's d = − 0.0.37) [22].…”

Factors related to implementation of an interprofessional communication concept in thoracic oncology: a mixed-methods study

“…This project primarily aimed to improve patient care outcomes (i.e. information needs, quality of life, mood [ 6 ]), while strengthening collaboration between specially trained physicians and nurse navigators.…”