White, V.M., Macvean, M.L., Grogan, S., D'Este, C., Akkerman, D., Ieropoli, S., . . . Sanson-Fisher, R. (2012). Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial. Psycho-Oncology, 21, 1053–1062.

To assess the effectiveness of a volunteer-delivered, tailored telephone-based intervention in reducing unmet supportive care needs and elevated levels of anxiety and depression among people with colorectal cancer

The intervention utilized a checklist of unmet needs that patients with colorectal cancer completed. Specially trained volunteers then followed up with patients, by means of telephone consultation, to review needs and devise an action plan.

• The study reported on a sample of 653 patients with colorectal cancer.
• Mean patient age was 64.57 years (SD = 9.2 years).
• The sample was 40.5% female and 59.5% male.
• Of sample patients, 78% were married; 49% had undergone chemotherapy, 89% had undergone surgery, and 10% had undergone radiotherapy; and almost 90% had at least a high school education.

• Outpatient setting
• Australia

Transition phase of care

Randomized controlled trial

• Supportive Care Need Survey (SCNS)
• Hospital Anxiety and Depression Scale (HADS)
• Nine-item colorectal cancer symptom checklist (developed for study)
• Eleven-item questionnaire on the use of supportive care services (developed for study)
• Medical Outcome Study Social Support Survey (MOS-SSS)

• The prevalence of elevated anxiety decreased over time in the intervention group (p < 0.01).
• Compared to the control group, the intervention group reported a greater use of services (p < 0.01).

This study suggests that a volunteer-delivered, telephone-based intervention is plausible and acceptable to patients with cancer and that the intervention was effective in getting patients to use available services. This approach was associated with reduced anxiety over time, but did not have an impact on depression or prevalence of unmet needs as identified by the patients.

• The study design lacked an attentional control.
• The study did not include discussion regarding supportive services utilized and whether they met patients’ unmet needs.
• The intervention was delivered to patients three to four months postdiagnosis, and the highest period of unmet needs may actually be sooner in the treatment trajectory.

Tailoring support and interventions to only those patients with unmet needs might be a better allocation of resources while producing significant results.