1664P - Early integration of psycho-oncology in cancer care: A model of care from a quaternary care government hospital in India and its patient related outcomes

Background

Despite important implications for patient outcomes, psycho-oncology care (POC) remains underappreciated in low-middle income countries like India. Screening in our patient population revealed high distress levels, among both patients/caregivers and emphasized barriers in accessing mental health care. Our study tests a model of care which proposes early integration of POC in a clinical cancer care setting.

Methods

A multidisciplinary team of ten healthcare professionals, including oncologists, psychologists, oncology nurses and social workers, developed the proposed model. The key components and interventions were: (1) linking counsellor consultation with first patient registration (2) co-counselling of patients and caregivers pre, during and post treatment (3) accessibility of psychologists in inpatient departments through joint ward rounds with treating clinician.

Results

Between Dec 2023 to Mar 2024, 1674 patients reported to Radiation Oncology OPD and 265 had inpatient admissions. The implementation of this model resulted in 31.9% increase in psychological counsellor consultations for outpatients (5.4% to 37.3%), and 82.6% increase for inpatients (12.2% to 94.8%). It also showed 62.68% increase in co-counselling (16.6% to 79.46%). Counsellors flagged off important issues like fear of recurrence or infertility, intimacy issues and reluctance to continuing therapy which patients were hesitant in sharing with the treating physician. Patient reported satisfaction levels evaluated using the OUT-PATSAT35 questionnaire also increased from 62% to 75%.

Conclusions

This model highlights simple ways to prioritise accessibility to mental healthcare in resource limited settings, without adding to the physician work burden and resulting in positive patient outcomes. Increased counsellor accessibility could also be attributed to employing more manpower (3 counsellors versus 1 prior to the study). Despite advising counselling at first contact, not all patients reported for it highlighting a significant barrier to mental therapy. Longer follow up is warranted to evaluate this model’s effectiveness and sustainability.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

N.Bisht.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.