Structural distress screening and supportive care for patients with lung cancer on systemic therapy: A randomised controlled trial

• Published in: European journal of cancer (1990) Vol. 72; pp. 37 - 45
• Main Authors: Geerse, O.P, Hoekstra-Weebers, J.E.H.M, Stokroos, M.H, Burgerhof, J.G.M, Groen, H.J.M, Kerstjens, H.A.M, Hiltermann, T.J.N
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2017; Elsevier Science Ltd
• Subjects: Adult; Aged; Antineoplastic Agents - therapeutic use; Anxiety; Anxiety - prevention & control; Cancer; Chemotherapy; Delivery of Health Care, Integrated - methods; Depression - prevention & control; Distress screening; End of life; Female; Health care; Hematology, Oncology and Palliative Medicine; Humans; Lung cancer; Lung Neoplasms - nursing; Lung Neoplasms - psychology; Lung Neoplasms - therapy; Male; Medical diagnosis; Mental depression; Middle Aged; Mood; Patient Satisfaction; Patients; Psychiatric Nursing - methods; Quality of Life; Randomization; Side effects; Stress, Psychological - prevention & control; Supportive care; Surveys and Questionnaires; Survival; Systemic therapy; Systemic therapy; Supportive care; Lung cancer; Distress screening; Quality of life
• DOI: 10.1016/j.ejca.2016.11.006
• ISSN: 0959-8049

Abstract Introduction Gaining regular insight into the nature and severity of distress by a psychosocial nurse coupled with referral to psychosocial and/or paramedical healthcare provider(s) is an experimental supportive care approach. We sought to examine the effects of this approach on quality of life (QoL), patient's mood and satisfaction, end-of-life care and survival in patients with lung cancer. Methods Patients with newly diagnosed or recurrent lung cancer starting systemic therapy were randomly assigned to receive usual care or the experimental approach. Patients were followed up at 1, 7, 13 and 25 weeks after randomisation with the EORTC-QLQ-C30, the European Quality of Life-5D, the Hospital Anxiety and Depression Scale and the Patient Satisfaction Questionnaire-III. Primary outcome was the mean change in the EORTC-QLQ-C30 global QoL-score between 1 and 25 weeks. Results A total of 223 patients were randomised of whom 111 (50%) completed all four assessments (44% in the usual care group versus 55% in the experimental group). No significant difference was found in the mean change global QoL-score (−2.4, 95% CI: 12.1–7.2; P  = 0.61), nor in the other patient-reported outcomes. Fewer patients in the experimental group received chemotherapy shortly before the end-of-life, and median survival was comparable (10.3 versus 10.1 months, P  = 0.62). Of the 112 dropouts, 33 died and 79 discontinued participation for other reasons. Conclusions This supportive care approach neither improved QoL nor other patient-reported outcomes in patients with lung cancer. However, it reduced the use of chemotherapy shortly before the end of life. Possibly, (late) side effects of systemic therapy may have obscured effects of our intervention on QoL. Clinical trial registration NTR3540.