Computer-Assisted Communication

To determine if patients assigned to either of two interventions for supportive care would report decreased levels of anxiety, depression, and unmet supportive care needs compared to patients receiving usual care

Patients were surveyed via computer-assisted telephone interview (CATI) to provide feedback to a telephone caseworker (TCW) or the patient’s physician at baseline, three months, and six months. The information obtained from the CATI was used to provide feedback to the caseworker in the TCW model, or to the physician in the oncologist/general practitioner (O/GP) model. In the TCW model, participant feedback information from CATIs was forwarded to the caseworker via email. The TCW then contacted participants to address areas of concern and refer to appropriate resources. In the O/GP model, feedback generated from the CATIs was mailed to both oncologists and GPs for discussion with the patients at the next appointment.

• The study analyzed a final sample of 333 patients (females: 71%–73%; males: 27%–29%).
• Patient age ranged from 28 to 75 years across groups.
• Patients were diagnosed with colorectal or breast cancer; mean time since diagnosis at baseline in all groups was 6.3 months.
• Of the sample, 17%–21% had no treatment, 47%–59% had chemotherapy, and 12%–16% had radiotherapy. Eight patients had surgery,
• The majority (73%–78%) of patients were married, and 50%–60% were not currently employed.

• Multisite
• Outpatient setting
• United Kingdom

• Patients were undergoing the active treatment phase of care.
• The study has clinical applicability for late effects and survivorship.

A randomized controlled trial design was used.

• Hospital Anxiety and Depression Scale (HADS)
• European Organization for Research and Treatment of Cancer (EORT) Quality of Life Questionnaire–version 3
• Supportive Needs Survey Short Form (34 items on a five-point scale across domains of physical and daily living, psychological, patient care and support, health system and information, and sexuality)
• Needs Assessment for Advanced Cancer Patients Questionnaire

No overall intervention effect was observed. TCW participants were more likely to have referrals for unmet psychological needs, daily living, health service/information, and physical needs (p < 0.01).

Findings suggest that use of a TCW can be helpful in improving supportive care in terms of communication and provision of referrals for care in patients with cancer. Neither of the models tested demonstrated any significant intervention effect for anxiety, depression, or quality of life over the time frame of this study.

• Participants had low levels of depression and anxiety at baseline, and most patients were more than six months out from time of diagnosis.
• Reviewers had limited ability to compare actions of physicians versus caseworkers due to lack of relevant documentation provided by the physicians.
• All patients participated in the CATI, which would have potentially enhanced communication in all the study groups in its own right. This could have confounded findings associated with other specific models.

Additional research in this area should incorporate at-risk populations at a time closer to diagnosis. Results suggest that CATIs and involvement of caseworkers may be helpful to enhance supportive care and patient communication with providers.