RESEARCH REPORT - Peter MacCallum Cancer Centre

a ranDoMiseD ControLLeD triaL of a taiLoreD, eviDenCe-BaseD intervention to
enhanCe outCoMes for patients startinG CheMotherapY
Cancer patients receiving chemotherapy commonly suffer pre-treatment anxiety and demand high levels of self-care information, suggesting that current patient
preparation for chemotherapy is sub-optimal. While there is level 1 evidence that tailored patient education interventions can improve health outcomes and further
level 1 evidence to guide preparation of patients for potentially threatening medical procedures, this has not previously been systematically applied in the prechemotherapy
setting. Using a randomised controlled trial and utilising the
potentially threatening procedures literature, the study aimed to assess the
impact of tailored preparatory information about cancer chemotherapy on
psychological morbidity, anxiety and depression, severity of treatment sideeffects
and confidences in coping with chemotherapy. Patients with breast
cancer, lymphoma or gastro-intestinal cancer were invited to participate in
the study following their initial medical consultation if they were receiving
chemotherapy for the first time and spoke English. After completing baseline
measures, patients were randomised to receive usual chemotherapy education
or the intervention. The intervention comprised four stages: a preparatory
chemotherapy video and pre-chemotherapy question prompt sheet; an
individual, pre-treatment face-to-face session, tailored to the person’s needs
and drug regimen, which included sensory and procedural information on
receiving chemotherapy, responding to psychological concerns, coaching
on self-care and relaxation, and individualised take-home information;
a booster telephone session shortly after first cycle; and a booster faceto-face
session just before the second cycle. Patients were administered
follow-up questionnaires before the first and third cycles of chemotherapy.
The study recruited 192 participants (usual care = 94, intervention = 98). It
was found that participants receiving low-toxicity chemotherapy reported
lower psychological distress than participants who received high-toxicity
chemotherapy (p < .05). Overall, at baseline, approximately half of the
participants reported either anxiety or depression scores greater than 8,
indicating possible clinical levels. This finding supports the need for support Dr Michael Jefford, Professor Sanchia Aranda, Dr Penny Schofield.
interventions for patients pre-chemotherapy setting. The main analysis of
differences between experimental groups is currently underway.
Implementation of supportive needs screening
tool into clinical practice.
Identifying and addressing supportive care needs
are critical for effective supportive care service
provision. A Peter Mac Supportive Needs Screening
Tool (Peter Mac SNST) was developed to screen
for supportive care needs and has currently been
adopted as part of clinical practice by some
tumour streams. The process of development
included a pilot study of the new tool to evaluate
the acceptability and clinical usability of the
tool for patients and clinicians. Evaluation of the
psychometric properties and user acceptability
of the new instrument has confirmed that the
Peter Mac SNST is reliable, valid and acceptable.
The implementation plan to roll out this tool as
usual care has been endorsed from the Clinical
Governance Committee and is now proceeding.
The transition from treatment completion for
cancer through to survivorship: A systematic
process to develop a patient educational DVD
and companion booklet.
More and more people are surviving cancer.
However, there are few resources available for
patients at this juncture. This project aimed to
develop an evidence-based resource for cancer
survivors. Focus groups were conducted to establish
the DVD and booklet content. The DVD was
developed according to a recommended bestpractice
framework. Filmed interviews with 13
cancer survivors and evidence-based commentary
by two health professionals made up the DVD,
producing a 52 minute long DVD
with nine segments. In the evaluation, both cancer
survivors and health professionals rated the DVD and
booklet as informative, relevant, easy to understand
and useful for survivors. Since completion, over
6,000 copies of the DVD have been distributed
widely within Victoria and New South Wales. This
work has formed the basis for a program of research
on survivorship: it is intended that the DVD will be
used as an essential component of a comprehensive
follow-up strategy with cancer survivors.
Meeting the needs of men with prostate cancer
using a consumer-driven multidisciplinary
care approach.
This NHMRC-funded study examines the
effectiveness of a multidisciplinary care program
to reduce the complex and often chronic needs of
men receiving radiotherapy for early prostate cancer
using a randomised controlled trial involving 400
men. The intervention is tailored to patient needs
and involves a combination of individual and groupbased
information sessions delivered by a specialist
urology nurse at key times throughout treatment.
It is expected that patients randomly allocated to
the intervention group will report a decrease in
psychological and informational needs, an increase
in quality of life and a decrease in depression or
anxiety compared with men receiving usual care.
The study has been running for 18 months at East
Melbourne and will open shortly at Moorabbin:
over 70 men have been recruited thus far.
presentation highlights
Carl Baravelli
– 34th COSA Annual Scientific Meeting (ASM),
Adelaide, SA, November 2007 (Presenter).
Dr Michael Jefford
– ECCO 14: the 14th European Cancer Conference,
Barcelona, July 2007 (Poster).
– World Congress of Psycho-Oncology, London,
UK, September 2007 (Poster).
– American Society of Clinical Oncology Annual
Meeting, Chicago, USA, May 2007 (Poster).
– Clinical Oncological Society of Australia Annual
Scientific Meeting, Adelaide, SA, November
2007 (Speaker).
Dr Linda Mileshkin
– Screening for the Supportive Care Needs of
Patients with Lung Cancer identifies high
levels of unmet need.
– 12th World Conference on Lung Cancer, Seoul,
Korea, September 2007 (Poster).
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