HuCare Quality Improvement Strategy for Psychosocial Care Positively Affects Emotional Elements of Health-Related Quality of Life

CHICAGO — Results from a clinical trial (ClinicalTrials.gov Identifier: NCT03008993) aimed at implementing evidence-based psychosocial care for patients with cancer through a program that includes communication training for healthcare providers, assistance and training in barrier identification for the oncology team, patient distress screening, and patient education proved the program to be effective in improving emotional health-related quality of life (HR-QoL), according to results presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.

The stepped-wedge design randomized control trial enrolled 762 patients, assigning 400 to the intervention and 362 to usual care. Patients across both arms had genitourinary and gynecologic cancers (299 patients), lung and head and neck cancers (155 patients), breast cancer (135 patients), gastrointestinal cancers (105 patients), and other/unknown cancers (68 patients). Treatments that patients experienced included chemotherapy, molecular targeting, immunotherapy, and/or monotherapy; with some patients experiencing a combination of treatments. Characteristics such as sex, age, and education were relatively equal across the study arms.

After univariate analysis, factors such as anxiety at baseline (P <.001), the ability to have social needs met (P =.001), age (P =.008), and sex (P =.079) influenced the changes within the emotional domain for individual scores detected at baseline and at 3-month follow-up. “Patients with a high level of anxiety at baseline and who have unmet social needs have a low quality of life and deserve special attention, intervention, and supportive care,” explained Rodolfo Passalacqua, MD, of the Istituti Ospitalieri di Cremona in Italy, during his presentation.

The 16-week intervention included a 3-day communication skill training course for all physicians and nurses and a 1-day training for psychologists followed by 4 onsite visits during weeks 7 to 16 from the improvement team that sought to assist the oncology care team staff with improving motivation while identifying obstacles and solutions. A referring nurse was assigned to each patient in the first cycle of therapy. In addition, patients were provided with a question prompt list and were screened for psychological distress and social needs.

“This study is the first randomized clinical trial demonstrating the effectiveness of an implementation strategy on the emotional domain of HR-QoL,” Dr Passalacqua concluded.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.

Reference

Passalacqua R, Iezzi E, Annunziata MA, et al. Integrating psychosocial care into routine cancer care: a stepped-wedge design cluster randomized controlled trial (SWD-RCT) to evaluate effectiveness of the HuCare Quality Improvement Strategy (HQIS) on health-related quality of life (HRQoL). Presented at: 2019 ASCO Annual Meeting; May 31 to June 4, 2019; Chicago, IL. Abstract 6515.