William Small1, Stephanie L Pugh2, Lynne I Wagner3, Jeffrey Kirshner4, Kulbir Sidhu5, Martin J Bury6, Albert S DeNittis7, Tracy E Alpert4, Binh Tran8, Beatrice F Bloom9, Julie Mai10, Deborah Watkins Bruner11. 1. Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, Illinois. Electronic address: wmsmall@lumc.edu. 2. NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania. 3. Wake Forest School of Medicine, Winston-Salem, North Carolina. 4. Hematology-Oncology Associates of CNY CCOP, East Syracuse, New York. 5. Southeast Cancer Control Consortium CCOP/Duke University, Winston-Salem, North Carolina. 6. Grand Rapids Clinical Oncology Program, Grand Rapids, Michigan. 7. Main Line CCOP, Philadelphia, Pennsylvania. 8. Northern Indiana Cancer Research Consortium CCOP, South Bend, Indiana. 9. North Shore University Hospital CCOP, Manhasset, New York. 10. Mercy Hospital St Louis, St. Louis, Missouri. 11. Emory University, Atlanta, Georgia.
Abstract
PURPOSE: NRG/RTOG 0841 assessed the feasibility of a depression screening procedure in patients receiving radiation therapy (RT). As a secondary endpoint, availability and barriers to psychosocial care data were collected in hopes of providing recommendations for improved psychosocial care among patients receiving RT. METHODS AND MATERIALS: Patients starting RT were prospectively recruited and assessed with self-reported distress screening tools. Patients exceeding a validated cutoff and a sample of patients who screened negative received the Structured Clinical Interview for DSM-IV (SCID) mood disorder modules via telephone. During that SCID evaluation, patients completed a validated scale ranking interview on barriers to psychosocial care and interest in various psychosocial intervention modalities. RESULTS: A total of 463 patients from 35 community-based and 2 academic RT oncology sites were recruited. Of the 455 eligible, 75 (16%) exceeded screening cutoffs for depressive symptoms. From this group, 78 patients completed the SCID; most were female (76%), white (88%), and had breast cancer (55%). Overall, the most common barriers to treatment, regardless of insurance, were costs (58%), daily responsibilities (44%), and physical health symptoms (38%). Patients from RT facilities without mental health services were significantly more likely to report difficulty with physical health problems, specifically serious illness and walking, compared with those treated at RT facilities with services (P = .013 and P = .039, respectively). Overall, there was interest in obtaining psychosocial services with face-to-face counseling at the cancer center and printed educational materials as the most commonly preferred interventions. Patients with difficult barriers to psychosocial interventions were significantly less interested in support away from the cancer center (P = .016), telephone and Internet counseling (P = .0062 &P = .011), and Internet support (P = .0048). CONCLUSION: Radiation oncology patients are interested in obtaining psychosocial services but face barriers to access to mental health services including cost, debilitating symptoms, and time constraints that prevent adequate care.
PURPOSE: NRG/RTOG 0841 assessed the feasibility of a depression screening procedure in patients receiving radiation therapy (RT). As a secondary endpoint, availability and barriers to psychosocial care data were collected in hopes of providing recommendations for improved psychosocial care among patients receiving RT. METHODS AND MATERIALS: Patients starting RT were prospectively recruited and assessed with self-reported distress screening tools. Patients exceeding a validated cutoff and a sample of patients who screened negative received the Structured Clinical Interview for DSM-IV (SCID) mood disorder modules via telephone. During that SCID evaluation, patients completed a validated scale ranking interview on barriers to psychosocial care and interest in various psychosocial intervention modalities. RESULTS: A total of 463 patients from 35 community-based and 2 academic RT oncology sites were recruited. Of the 455 eligible, 75 (16%) exceeded screening cutoffs for depressive symptoms. From this group, 78 patients completed the SCID; most were female (76%), white (88%), and had breast cancer (55%). Overall, the most common barriers to treatment, regardless of insurance, were costs (58%), daily responsibilities (44%), and physical health symptoms (38%). Patients from RT facilities without mental health services were significantly more likely to report difficulty with physical health problems, specifically serious illness and walking, compared with those treated at RT facilities with services (P = .013 and P = .039, respectively). Overall, there was interest in obtaining psychosocial services with face-to-face counseling at the cancer center and printed educational materials as the most commonly preferred interventions. Patients with difficult barriers to psychosocial interventions were significantly less interested in support away from the cancer center (P = .016), telephone and Internet counseling (P = .0062 &P = .011), and Internet support (P = .0048). CONCLUSION: Radiation oncology patients are interested in obtaining psychosocial services but face barriers to access to mental health services including cost, debilitating symptoms, and time constraints that prevent adequate care.
Authors: Grietje Bouma; Jolien M Admiraal; Elisabeth G E de Vries; Carolien P Schröder; Annemiek M E Walenkamp; Anna K L Reyners Journal: Crit Rev Oncol Hematol Date: 2015-01-31 Impact factor: 6.312
Authors: A M H Krebber; L M Buffart; G Kleijn; I C Riepma; R de Bree; C R Leemans; A Becker; J Brug; A van Straten; P Cuijpers; I M Verdonck-de Leeuw Journal: Psychooncology Date: 2013-09-16 Impact factor: 3.894