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17.08.2016 | Original Article

A tiered multidisciplinary approach to the psychosocial care of adult cancer patients integrated into routine care: the PROMPT study (a cluster-randomised controlled trial)

verfasst von: Jane Turner, Brian Kelly, David Clarke, Patsy Yates, Sanchia Aranda, Damien Jolley, Andrew Forbes, Suzanne Chambers, Maryanne Hargraves, Lisa Mackenzie

Erschienen in: Supportive Care in Cancer | Ausgabe 1/2017

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Abstract

Purpose

A stepped-wedge cluster-randomised controlled trial was conducted to evaluate the feasibility and effectiveness of a brief psychosocial intervention for depressed cancer patients, delivered by trained front-line health professionals in routine clinical care.

Methods

Nine hundred two patients were assessed across four treatment centres which were allocated in random order from control epoch to intervention epoch. Eligible patients had Hospital Anxiety and Depression Scale (HADS) scores of 8 or greater. Of eligible patients, 222 were recruited in control epoch and 247 in intervention epoch. Twenty-seven health professionals (HPs) were trained to deliver the psychosocial intervention consisting of up to four sessions, tailored to patient symptoms and distress. HPs participated in group supervision with a psychiatrist. The primary outcome, analysed by intention to treat, was depression measured with the HADS at 10 weeks after receiving the intervention.

Results

At 10-week follow-up, there were no significant differences in HADS score for the 181 patients in control epoch and 177 in intervention epoch (adjusted difference −1.23, 95 % CI −3.81––1.35, p = 0.35). Patients with disease progression who received the intervention experienced significant benefits in unmet practical support needs including care and support, information, and physical and daily living.

Conclusion

A brief psychosocial intervention delivered by front-line oncology health professionals is feasible to deliver but is insufficient as a stand-alone treatment for depression in cancer patients. Psychosocial interventions should be targeted to populations most likely to experience benefit.

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Titel: A tiered multidisciplinary approach to the psychosocial care of adult cancer patients integrated into routine care: the PROMPT study (a cluster-randomised controlled trial)
verfasst von: Jane Turner
Brian Kelly
David Clarke
Patsy Yates
Sanchia Aranda
Damien Jolley
Andrew Forbes
Suzanne Chambers
Maryanne Hargraves
Lisa Mackenzie
Publikationsdatum: 17.08.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 1/2017
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3382-0

Springer Medizin

A tiered multidisciplinary approach to the psychosocial care of adult cancer patients integrated into routine care: the PROMPT study (a cluster-randomised controlled trial)