[Show abstract][Hide abstract] ABSTRACT: Little is known about the nature of psychosocial care delivered by oncologists. The goal of this study was to survey oncologists about their management of psychosocial distress, referencing the National Comprehensive Cancer Network guidelines.
A random sample of 1,000 oncologists were sent an e-mail requesting their participation in an online survey; nonrespondents were sent the survey through postal mail. Regression analyses were conducted to identify independent predictors of care.
Forty-six percent (448 of 965) of oncologists responded. Practice locations included: community (63%), cancer center (25%), and hospital (7%). Respondents estimated that over one-third of their patients (mean+/-SD=38%+/-22%) experience psychosocial distress warranting intervention, although only 225 of 447 (50%) indicated having mental health services affiliated with their practice. Nearly half (212 of 447, 47%) reported only initiating a referral for psychosocial services, and 214 of 447 (48%) reported both making a referral and starting psychiatric medications, mainly selective serotonin reuptake inhibitors and benzodiazepines.
Most oncologists delivered some level of psychosocial care, although only half had affiliated mental health services.
[Show abstract][Hide abstract] ABSTRACT: Little is known about the dissemination and uptake of National Comprehensive Cancer Network (NCCN) guidelines for psychosocial distress in oncology practice. This study surveyed oncologists about their awareness of NCCN guidelines on psychosocial distress and their methods of screening patients for distress. In all, 1,000 oncologists practicing in the United States who were members of the American Society of Clinical Oncology were asked to complete an anonymous questionnaire. Predictors of routine screening for distress were identified using logistic regression. Overall, 46% (448/965) of the oncologists responded. Almost two thirds (63.4%) practiced in the community, 27.2% practiced in cancer centers, and 6.9% practiced in hospitals. Less than one-third (32.3%) reported being at least somewhat familiar with NCCN guidelines. Two-thirds (65.0%; 95% confidence interval, 60.6-69.4) reported screening patients for distress routinely, but only 14.3% used a screening instrument. Independent predictors for screening patients for distress included availability of mental health services, knowledge of NCCN guidelines, experience, lack of time, uncertainty about identifying distress, and female gender of the practitioner. NCCN guidelines for psychosocial distress do not appear to be widely disseminated. Whereas the majority of oncologists reported routinely screening patients for distress, only a small percentage followed the guidelines by using a screening instrument. Future efforts should focus on the dissemination and validation of the NCCN guidelines.