2111P - The value of multiple psychometric tools for distress screening and referral in a cancer population

Background

Psychometric assessment tools are widely available but underutilized in daily oncology practice. The aim of this study was to evaluate the role of multiple psychometric scales in identifying cancer patients in distress who need Psycho-Oncology management.

Methods

Colorectal cancer patients were prospectively asked to complete a survey including 3 psychometric scales (GAD-7, PHQ-9, PC-PTSD-5). Those scoring high on at least one scale (GAD-7 score ≥ 10, PHQ-9 score ≥ 10, PC-PTSD-5 score ≥ 4) were offered referral to the Psycho-Oncology service. Those accepting the referral were further triaged by members of this service via a standardized semi-structured interview. Patients were divided into three groups: those accepted by the Psycho-Oncology service, those declined the referral and those discharged from the service with no need for further intervention. Outcomes were compared with the analysis of variance test (ANOVA).

Results

Fifty-four patients (30 females) of median age 60 years (range 36-81) were prospectively evaluated. 20 patients (37%) reported their cancer was under control, 15 (28%) believed they had progressive disease, while 19 (35%) were uncertain. Approximately half patients (26; 48%) referred a prior history of a mental condition. The mean (±SE) scores for each psychometric scale were 10.96 (± 0.78), 12.79 (± 0.82), and 1.07 (± 0.21), respectively for GAD-7, PHQ-9, PC-PTSD-5. Thirty-four patients (63%) scored high on GAD-7, 40 (74%) on PHQ-9 and 8 (15%) on PC-PTSD-5. Almost half of the patients declined a referral (25, 46%), 22 (41%) were assessed by a Psycho-Oncologist and managed accordingly and 7 (13%) were discharged after the initial tirage. There was no statistically significant difference in the mean psychometric scores between the three identified groups (p<0.05).

Conclusions

Psychometric scales are useful screening tools to identify distress but cannot differentiate between general distress and psychological/psychiatric symptoms requiring specialist intervention. Psychometric scales should be used in conjunction with semi-structured interviews. The ‘screen and triage’ model should be further investigated as part of an integrated care model, to signpost cancer patients to appropriate support services.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Servier.

Disclosure

All authors have declared no conflicts of interest.