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The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial

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Abstract

Purpose

We examined whether multi-disciplinary stepped psycho-social care decreases financial problems and improves return-to-work in cancer patients.

Methods

In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for financial problems, consultation between doctor and patient, and the provision of social service. Outcomes were financial problems at the time of discharge and return-to-work in patients < 65 years old half a year after baseline. The analysis employed mixed-effect multivariate regression modeling.

Results

Thirteen wards were randomized and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Those who reported financial problems at baseline were less likely to have financial problems at discharge when they had received stepped care (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1, 0.7; p = 0.01). There was no evidence for an effect of stepped care on financial problems in patients without such problems at baseline (OR 1.1, CI 0.5, 2.6; p = 0.82). There were 399 patients < 65 years old who were not retired at baseline. In this group, there was no evidence for an effect of stepped care on being employed half a year after baseline (OR 0.7, CI 0.3, 2.0; p = 0.52).

Trial registration

NCT01859429

Conclusions

Financial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.

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Acknowledgements

We would like to acknowledge the time and effort of all doctors and nurses who helped in implementing this trial into daily routine in a large university hospital. We are also very grateful to all patients who participated in this trial.

Access to data

Susanne Singer had full access to all the data in the study and takes responsibility for the integrity of the data, the accuracy of the data analysis, and the decision to submit for publication. She also planned and conducted the data analysis.

Funding

This trial was funded by the German Federal Ministry of Health within the framework “Research within the German National Cancer Plan” (no. NKP-332-026). The grant provided salary support for Helge Danker and Julia Roick.

Author information

Authors and Affiliations

  1. Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany

    Susanne Singer

  2. University Cancer Center, University Medical Center Mainz, Mainz, Germany

    Susanne Singer

  3. Division of Medical Sociology, University of Halle, Halle, Germany

    Julia Roick

  4. Division of Neurosurgery, University Medical Center Leipzig, Leipzig, Germany

    Jürgen Meixensberger

  5. Division of Maxillofacial Surgery, University Medical Center Leipzig, Leipzig, Germany

    Franziska Schiefke

  6. Division of Obstetrics and Gynecology, University Medical Center Leipzig, Leipzig, Germany

    Susanne Briest

  7. Division of Otolaryngology, University Medical Center Leipzig, Leipzig, Germany

    Andreas Dietz

  8. Division of Radiation-Oncology, University Medical Center Leipzig, Leipzig, Germany

    Kirsten Papsdorf

  9. Division of Gastroenterology, University Medical Center Leipzig, Leipzig, Germany

    Joachim Mössner & Thomas Berg

  10. Division of Urology, University Medical Center Leipzig, Leipzig, Germany

    Jens-Uwe Stolzenburg

  11. Division of Medical Oncology, University Medical Center Leipzig, Leipzig, Germany

    Dietger Niederwieser

  12. Division of Social Work, University Medical Center Leipzig, Leipzig, Germany

    Annette Keller

  13. Division of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany

    Anette Kersting

  14. Division of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany

    Helge Danker

Authors
  1. Susanne Singer
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  2. Julia Roick
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  3. Jürgen Meixensberger
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  5. Susanne Briest
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  6. Andreas Dietz
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  7. Kirsten Papsdorf
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  8. Joachim Mössner
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  9. Thomas Berg
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  10. Jens-Uwe Stolzenburg
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  11. Dietger Niederwieser
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  12. Annette Keller
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  13. Anette Kersting
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  14. Helge Danker
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Corresponding author

Correspondence to Susanne Singer.

Ethics declarations

Ethical approval was granted by the University Medical Center Leipzig (no. 210-12-02072012).

Conflict of interest

We declare that there are no conflicts of interest.

Disclaimer

The German Federal Ministry of Health did not influence the trial design and procedures or the writing of this manuscript or the decision to submit it for publication.

Additional information

The manuscript was prepared in accordance with the CONSORT 2010 checklist (extension cluster-randomized trials).

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Singer, S., Roick, J., Meixensberger, J. et al. The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial. Support Care Cancer 26, 1851–1859 (2018). https://doi.org/10.1007/s00520-017-4024-x

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  • DOI: https://doi.org/10.1007/s00520-017-4024-x

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