Psychosocial screening effects on health‐related outcomes in patients receiving radiotherapy. A cluster randomised controlled trial

Abstract

Our results suggest that the use of a psychosocial screening instrument among patients receiving radiotherapy in itself does not sufficiently improve patients' health-related outcome. The effective delivery of psychosocial care depends upon several components such as identification of distress and successful implementation of screening procedures. One of the challenges is to get insight in the effects of early referral of cancer patients for psychosocial support because early referral might have a favourable effect on some of the patients' health-related outcomes.

Does a regular nurse‐led distress screening and discussion improve quality of life of breast cancer patients treated with curative intent? A randomized controlled trial

“…This finding is in line with other (nurse) intervention studies with the DT . Albeit, they used the DT in a different way and with a shorter follow‐up period . In this study, 20% to 49% of the patients experienced distress (DT ≥ 5) at one or more time‐points.…”

“…The main result is that using the DT by a nurse at regular time‐points did not improve global QOL 2 years after the end of treatment. This finding is in line with other (nurse) intervention studies with the DT . Albeit, they used the DT in a different way and with a shorter follow‐up period .…”

“…This relationship was also discussed in a review about predictors of distress in cancer patients . Randomized controlled trials (RCTs) that focused on the period of treatment and the first year of follow‐up did not establish evidence that distress screening with the DT improves hrQOL . At the start of our study, longitudinal screening on distress with a DT in cancer patients during and up to 2 years after treatment in an RCT was never performed.…”

Measuring psychosocial functioning in the radiation oncology clinic: a systematic review

“…Rahn et al [47] studied 523 breast cancer patients undergoing RT as a part of breast conservation and estimated 40% anxiety prior to RT, which declined over time. A Dutch cluster randomized trial by Braeken et al [67] with 568 general RT patients identified 21% anxiety, 7% depression, and 39% distress at 3 months following RT completion and concluded that distress screening alone does not alleviate psychosocial function decline. A recently reported (abstract-only) multi-institutional trial performed by the RT Oncology Group (RTOG 0841) of 455 general RT patients assessed at a single point prior to RT reported a 16.5% prevalence rate of depressive symptoms using the DT and other rapid instruments [4].…”

Psychosocial Care for Cancer Patients

“…Standardized and internationally validated instruments are available to assess psychosocial distress [8]. However, recently published results showed that early detection of distress and referral to psychosocial care does not automatically show a positive effect on a patient's quality of life and therefore should be embedded in a stepped-care program [9]. The stepped-care model comprises systematic identification of needs, integrated delivery of psychosocial care by care managers ranging from counseling to individual psychotherapy, and appropriate specialist supervision.…”