Resolving such barriers requires extensive and repeated training, which in turn may hamper the long-term effectiveness of a screening program. Discrepant findings, however, may be caused by barriers that impede the usefulness of the screenings, such as lack of qualification of the physicians in interpreting results or a lack of transformation of screening results into individualized support plans. Previous findings on the effects of screenings on well-being, communication and referral are mixed, and thus the general benefit of screening is often argued. In recent years, the general feasibility of electronic distress screenings in oncological routine care has been repeatedly demonstrated. Therefore, screening for distress to detect those in need is considered mandatory in comprehensive cancer care. Nevertheless, many distressed patients are not recognized by the treating clinicians and left untreated even though effective psychosocial interventions exist. Such symptomatology, conceptualized under the broader term distress, may worsen quality of life and even medical outcomes such as morbidity and mortality.
EPAS 3 SOFTWARE TRIAL
The trial was retrospectively registered (2/2021) at (number: NCT04749056).ĭue to multiple challenges in all areas of life, many cancer patients show elevated levels of mental burden such as depression or anxiety. Implications for Cancer Survivors: The screening may help to enhance self-management competencies among cancer survivors. Future studies should incorporate novel technologies and condense the procedure to its core factors. The effect on information level seems not to be generalizable to other aspects of oncological care. ConclusionsĮPAS may improve information about psychosocial services as well as utilization of and access to these services. At t2, the intervention was associated with a lower level of satisfaction with disease-related information ( p = .02). The intervention was associated with increased information level for all psychosocial services at t1 and t2 (all p < .001), increased use in some of these services at t1 and t2, respectively ( p ≤ .02), and better evaluation of access (e.g., more recommendations for services provided by physicians, p < .01). The average age was 60 years 46% were female. Of 1320 eligible patients across 11 clusters, 660 were included (50%). Conditional linear and logistic regressions were used to identify screening effects at t1 and t2. Outcomes included information level and use of/access to nine psychosocial services at UCCH, well-being (GAD-7, PHQ-9, SF-8), and treatment satisfaction (SCCC). Patients were assessed at baseline (t0), 3-month (t1), and 6-month (t2) follow-up. Patients in the intervention arm underwent the screening, controls received standard care. Patients were assessed within clusters, i.e., different oncological facilities of the competence network of the University Cancer Center Hamburg (UCCH).
We evaluated an electronic psycho-oncological adaptive screening (EPAS) which assesses objective indicators of care needs and subjectively perceived care needs and subsequently provides patient feedback with individualized recommendations about psychosocial care services.
Distress screening has become mandatory and essential in comprehensive cancer care.