Stepped Psychological Care for Patients with Head and Neck or Lung Cancer

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Stepped care programs can reduce costs and resource overutilization.
Stepped care programs can reduce costs and resource overutilization.

For patients with head and neck or lung cancer, stepped care programs (SC) to address psychological stress can reduce health care resource overutilization by first offering “effective yet least resource-intensive” treatment before stepping up treatment resource-intensity, when needed, according to a cost-utility study published in the Journal of Clinical Oncology.1

“SC is highly likely to be cost-effective,” reported lead study author Femke Jansen, the VU Medical Center, Amsterdam, Netherlands, and coauthors. Quality-adjusted life years (QALYs) were higher and cumulative costs lower for patients treated in SC compared to care-as-usual.

Among the 156 patients randomly assigned to receive SC or care-as-usual, the mean cumulative number of QALYs was 0.116 higher, and the cumulative costs were €3,950 (approximately $4,100 USD) lower for SC patients, the research team reported. Health-related quality of life was not significantly different between the two groups (P = .12, n.s.).


1. Jansen F, Krebber AMH, Coupe VMH, et al. Cost-utility of stepped care targeting psychological distress in patients with head and neck or lung cancer. J Clin Oncol. December 5, 2016. doi: 10.1200/JCO.2016.68.8739. [Epub ahead of print]

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