Following patient pathways to psycho-oncological treatment: identification of treatment needs by clinical staff and electronic screening

Abstract

Objective

In this retrospective investigation of patient pathways to psycho-oncological treatment (POT) we compared the number of POT referrals before and after implementation of electronic screening for POT needs and investigated psychosocial predictors for POT wish at a nuclear medicine department.

Methods

We extracted medical chart information about number of referrals and extent of follow-up contacts. During standard referral (November 2014–October 2015), POT needs were identified by clinical staff only. In the screening-assisted referral period (November 2015–October 2016), identification was supported by electronic screening for POT needs. Psychosocial predictors for POT wish were examined using logistic regression.

Results

We analysed data from 487 patients during standard referral (mean age 56.4years; 60.2% female, 88.7% thyroid carcinoma or neuroendocrine tumours) of which 28 patients (5.7%) were referred for POT. Of 502 patients in the screening-assisted referral period (mean age 57.0years; 55.8% female, 86.6% thyroid carcinoma or neuroendocrine tumours), 69 (13.7%) were referred for POT. Of these, 36 were identified by PO-screening and 33 by clinical staff. After PO-screening implementation, referrals increased by a factor of 2.4. The strongest predictor of POT wish was depressive mood (p<0.001). During both referral periods, about 15% of patients visited the PO outpatient unit additionally to inpatient PO consultations.

Conclusions

Our results provide evidence from a real-life setting that PO-screening can foster POT referrals, reduce barriers to express the POT wish, and hence help to meet psychosocial needs of this specific patient group. Differences between patients' needs, wish and POT uptake should be further investigated.

http://ift.tt/2ogIk64