Psychosocial Telephone Interventions for Cancer Patients: A Systematic Review

• Published in: Psycho-oncology (Chichester, England) Vol. 23; p. 72
• Main Authors: Okuyama, Sonia, Jones, Whitney, Ricklefs, Christine, Marcus, Al
• Format: Journal Article
• Language: English
• Published: Chichester Wiley Subscription Services, Inc 01.02.2014
• Subjects: Cancer; Emotional disorders; Intervention; Oncology; Research methodology; Systematic review; Telephone switching equipment
• ISSN: 1057-9249; 1099-1611

More than one third of cancer patients experience elevated psychosocial distress. As screening for distress becomes more common, the number of patients being referred for psychosocial care will increase. Psychosocial telephone interventions have been recommended as a convenient and exportable alternative to in-person interventions to address psychosocial distress. The present study seeks to review the efficacy of psychosocial telephone interventions for cancer patients as studied in randomized controlled trials (RCTs). We conducted a systematic review of RCTs published in peer-reviewed journals that evaluated psychosocial telephone interventions in adult cancer patients across the survivorship continuum. The search was last updated in March 2013. 480 articles were identified through the initial database search. After manual review, 13 were included, with an additional 7 studies identified by back-citation, for a total of 20 studies. Participants were largely Caucasian, highly educated, with mean age ranging from 49 to 75 years. Most participants were breast cancer patients (n=13). Sample sizes were generally small, with most patients recruited from large hospitals, including multi-site clinics and academic medical centers. Only one screened on the basis of psychosocial need. Interventions varied greatly in length and intensity. 8 studies reported significant effects post-intervention in the hypothesized direction on at least one psychosocial outcome measure. Of these 8 studies, 5 included more than one follow-up assessment, and of these only 1 reported significant effects on the last follow-up assessment. No clear commonalities were found among those studies that reported significant effects. Many methodological concerns and lack of consistency in adherence to CONSORT reporting guidelines were identified. This body of research would benefit from well-designed, theory-based RCTs with sufficient statistical power to provide more definitive evidence for intervention efficacy. This will probably require multi-institutional collaborations, guided by intervention and research methodology best practices. Psychosocial telephone interventions may decrease distress in cancer patients but larger RCTs are needed to demonstrate their efficacy, likely requiring multi-institutional collaborations, using rigorous methodology. Psychosocial telephone interventions are potentially effective in alleviating distress in cancer patients.