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Telephone monitoring of distress in patients aged 65 years or older with advanced stage cancer†‡§‖

A cancer and leukemia group B study

  1. Alice B. Kornblith PhD1,††,*,
  2. Jeannette M. Dowell MS2,
  3. James E. Herndon II PhD2,
  4. Beverly J. Engelman MS3,
  5. Susan Bauer-Wu DNSc, RN1,
  6. Eric J. Small MD4,
  7. Vicki A. Morrison MD5,
  8. James Atkins MD6,
  9. Harvey Jay Cohen MD7,
  10. Jimmie C. Holland MD3

Article first published online: 31 OCT 2006

DOI: 10.1002/cncr.22296

Issue

Cancer

Cancer

Volume 107, Issue 11, pages 2706–2714, 1 December 2006

Additional Information

How to Cite

Kornblith, A. B., Dowell, J. M., Herndon, J. E., Engelman, B. J., Bauer-Wu, S., Small, E. J., Morrison, V. A., Atkins, J., Cohen, H. J. and Holland, J. C. (2006), Telephone monitoring of distress in patients aged 65 years or older with advanced stage cancer. Cancer, 107: 2706–2714. doi: 10.1002/cncr.22296

Author Information

  1. 1

    Breast Oncology Program, Dana-Farber Cancer Institute, Boston, Massachusetts

  2. 2

    Cancer and Leukemia Group B Statistical Center, Duke University Medical Center, Durham, North Carolina

  3. 3

    Department of Psychiatry and Behavioral Sciences, Memorial-Sloan Kettering Cancer Center, New York, New York

  4. 4

    Department of Medicine and Oncology, University of California Comprehensive Care Center, University of California—San Francisco, San Francisco, California

  5. 5

    Section of Hematology/Oncology and Infections Diseases III E, Veterans Affairs Medical Center and the University of Minnesota, Minneapolis, Minnesota

  6. 6

    Southeast Cancer Control Consortium, Winston-Salem, North Carolina

  7. 7

    Center for Aging, Duke University and Veterans Affairs Medical Centers, Durham, North Carolina

  1. ††

    Fax: (617) 632-1930

*Women's Cancers Program-D 1210, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115

  1. †

    This article is a US Government work and, as such, is in the public domain in the United States of America.

  2. ‡

    Published in abstract form in Kornblith AB, Dowell JM, Herndon II JE, et al. Telephone monitoring: early identification of psychological, physical and social distress in older advanced stage cancer patients. Psychooncology. 2006; 15:S21-S22. Abstract VIII.

  3. §

    The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute.

  4. The authors dedicate this article to the memory of Ms. Sylvia Rosenberg, who served as an extraordinary telephone monitor in the study.

  5. ‖

    The following institutions participated in this study, listed with their grant support: CALGB Statistical Center, Durham, NC (Stephen George, PhD; supported by National Cancer Institute [NCI] Grant CA33601); Christiana Care Health Services, Inc. Community Clinical Oncology Program (CCOP), Wilmington, DE (Stephen Grubbs, MD; supported by NCI Grant CA45418); Dana Farber Cancer Institute, Boston, MA (George P Canellos, MD; supported by NCI Grant CA32291); Dartmouth Medical School-Norris Cotton Cancer Center, Lebanon, NH (Marc S. Ernstoff, MD; supported by NCI Grant CA04326); Duke University Medical Center, Durham, NC (Jeffrey Crawford, MD; supported by NCI Grant CA47577); Memorial Sloan-Kettering Cancer Center, New York, NY (Clifford Hudis, MD; supported by NCI Grant CA77651); Missouri Baptist Medical Center, St. Louis, MO (Alan P. Lyss, MD); Ohio State University Medical Center, Columbus, OH (Clara D Bloomfield, MD; supported by NCI Grant CA77658); Roswell Park Cancer Institute, Buffalo, NY (Ellis Levine, MD; supported by NCI Grant CA02599); Southeast Cancer Control Consortium Inc. CCOP, Goldsboro, NC (James N. Atkins, MD; supported by NCI Grant CA45808); State University of New York-Upstate Medical University, Syracuse NY (Stephen L. Graziano, MD; supported by NCI Grant CA21060); University of California at San Diego, San Diego, CA (Stephen L. Seagren, MD; supported by NCI Grant CA11789; University of California at San Francisco, San Francisco, CA (Alan P. Venook, MD; supported by NCI Grant CA60138); University of Chicago Medical Center, Chicago, IL (Gini Fleming, MD; supported by NCI Grant CA41287); University of Illinois Minority-Based, CCOP, Chicago, IL (Lawrence E. Feldman, MD; supported by NCI Grant CA74811); University of Minnesota, Minneapolis, MN (Bruce A Peterson, MD; supported by NCI Grant CA16450); University of Missouri/Ellis Fischel Cancer Center, Columbia, MO (Michael C. Perry, MD; supported by NCI Grant CA12046); University of North Carolina at Chapel Hill, Chapel Hill, NC (Thomas C. Shea, MD; supported by NCI Grant CA47559); Vermont Cancer Center, Burlington, VT (Hyman B. Muss, MD; supported by NCI Grant CA77406); Wake Forest University School of Medicine, Winston-Salem, NC (David D Hurd, MD; supported by NCI Grant CA03927); Walter Reed Army Medical Center, Washington, DC (Thomas Reid, MD; supported by NCI Grant CA26806); Washington University School of Medicine, St. Louis, MO (Nancy Bartlett, MD; supported by NCI Grant CA77440); Weill Medical College of Cornell University, New York, NY (Scott Wadler, MD; supported by NCI Grant CA07968); and Western Pennsylvania Cancer Institute, Pittsburgh, PA (Richard K. Shadduck, MD).

Publication History

  1. Issue published online: 17 NOV 2006
  2. Article first published online: 31 OCT 2006
  3. Manuscript Accepted: 7 SEP 2006
  4. Manuscript Revised: 6 SEP 2006
  5. Manuscript Received: 25 APR 2006

Funded by

  • National Cancer Institute (NCI). Grant Numbers: CA31946, CA33601, CA60138, CA16450, CA45808, CA47577
  • CALGB Foundation

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Keywords:

  • adaptation;
  • psychosocial;
  • quality of life;
  • aged

Abstract

BACKGROUND.

Significant barriers to cancer patients receiving mental health treatment for distress have been reported in the literature. The objective of the current study was to determine whether distress in older patients (aged 65 years and older) would be reduced with educational materials (EM) supplemented by monthly telephone monitoring (TM) (TM + EM) compared with the use of EM alone because of more timely referrals to appropriate health professionals.

METHODS.

One hundred ninety-two older patients with breast, prostate, and colorectal cancers who had advanced disease and currently were receiving treatment were randomized to receive either TM + EM or EM alone. One hundred thirty-one patients were evaluated by telephone interview for psychologic and physical distress and for social support at baseline and at 6 months using the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer (EORTC)-QLQ-C30 quality-of-life questionnaire, and the Medical Outcomes Study (MOS) Social Support Survey. Patients who in the TM + EM group were called monthly for 6 months to monitor their distress using the HADS and EORTC physical symptom items and the MOS Social Support Survey items, with cutoff levels were established to indicate which patients were in greater distress. Those patients who scored above the cutoff levels were referred to their oncology nurse for referral to the appropriate professional. Patients in the EM group received written materials regarding cancer-related psychosocial issues and available resources.

RESULTS.

At 6 months, patients in the TM + EM group reported significantly less anxiety (HADS; P < .0001), depression (HADS; P = .0004), and overall distress (HADS; P < .0001) compared with patients in the EM group.

CONCLUSIONS.

Monthly monitoring of older patients' distress with TM and EM along with referral for appropriate help was found to be an efficient means of reducing patients' anxiety and depression compared with patients who received only EM. Cancer 2006. Published 2006 American Cancer Society.

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