Distress screening for program building: Similarities and differences among patient populations.
Williams A, Goldberg W, Varkas T, and Ryan M. Distress screening for program building: Similarities and differences among patient populations. Psycho-Oncology 2017; 26:100.
Purpose: The IOM states screening for distress and psychosocial health needs is a critical first step in providing high-quality cancer care. However, high-quality care goes beyond screening and addressing individual patient concerns in that moment. Distress-screening data should also be used to develop patient-centered programs at a health care system level. This study examines similarities and differences in areas of distress across 11 types of cancer based on distress screening data. Methods: Data were obtained from the Cancer Care Assessment (c) patients complete at their first medical oncology appointment, their radiation oncology simulation visit, or at their second post-op appointment with surgical oncology. Chart review was used to abstract demographic and cancer diagnosis. Cancer diagnoses were divided into 11 cancer types: blood/bone, lung, GI, pancreas, breast, head and neck, brain/neurological, urologic, gynecologic, dermatologic, and liver/ kidney. Those areas of distress rated as a “moderate” or “severe” were considered significant areas of distress. Results: The average patient age ranged from 55 years (brain/neurological) to 70 years (dermatologic) (N = 1613). Aside from breast and gynecologic, a majority of patients were male. Areas of common distress were pain, fatigue, sleep, weight loss, and anxiety. Areas of specific distress varied by cancer type. For example, liver/kidney endorsed concern about end of life decisions while brain/neurological endorsed difficulty coping with treatment side effects. There were also differences in needs both within and across cancer type-based on gender, age, and urban vs suburban residence. Conclusions: While many areas of distress are common across cancer types, there are other areas of distress specific to a particular cancer type. Based on this data, a health care system can develop supportive oncology programs that address both the common and the specific areas of distress to deliver more patient-centered care.