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psycho-oncology
1462PD INTEGRATION OF PSYCHOSOCIAL CARE INTO ROUTINE
CANCER CARE: FINAL RESULTS OF A LARGE
COLLABORATIVE, HOSPITAL-BASED, QUALITY
IMPROVEMENT STUDY (HUCARE PROJECT)
R. Passalacqua 1 , C. Caminiti 2 , M.A. Annunziata 3 , C. Borreani 4 , J. Saleri 5 ,
F. Diodati 6 , L. Isa 7 , S. Filiberti 1 , D. Fagnani 8 and G. Donati 1
1 Oncology Division, Istituti Ospitalieri di Cremona, Cremona, ITALY,
2 Epidemiology, Azienda Ospedaliera Universitaria di Parma, Parma, ITALY,
3 Psychology, CRO Aviano, Pordenone, ITALY, 4 Psychology, INT Milan, Milan,
ITALY, 5 Oncology, Istituti Ospitalieri, Cremona, ITALY, 6 Epidemiology, Azienda
Ospedaliera, Parma, ITALY, 7 Oncology, ASL Melegnano, Milan, ITALY,
8 Oncology, AO Vimercate, Milan, ITALY
Background: Incorporating psychosocial research into practice is challenging. Aim of
this study is to assess the feasibility in real life of interventions which have been
tested in RCTs and have demonstrated to improve pts psychosocial conditions.
Methods: This is an implementation study of five EBM interventions, conducted in
28 centers. We adopted the model of Pronovost [BMJ 2008], which includes: context
analysis to identify local barriers, introduction of the interventions, and evaluation of
how many pts receive the recommended interventions. Primary EPs: degree of
implementation detected in a blinded fashion by external trained personnel. EBM
interventions included: 1) communication courses for doctors and nurses [Ann
Oncol 2011]; 2) use of a question prompt list (QPL) [Cancer 2008]; 3) creation of
the Point of Information and Support (PIS) in the ward [J Clin Oncol 2009]; 4)
identification of a referring nurse (RN) for informing and educating pts [J Clin Nurs
2010]; 5) screening of distress and social needs [J Natl Compr Canc Netw 2010].
Results: 33 centers applied to partecipate, 29 were eligible and 28 are evaluable. Final
blinded analisys was conducted on 305 consecutive patients. 156 oncologists and 401
nurses attended the 3 days training course. An Australian QPL was subjected to
cross-cultural adaptation, yielding the first validated Italian QPL [BMC Health Serv
Res 2010]. 25 centers (89%) have successfully implemented the majority of
interventions; 1 is too early and 3 centers failed for various reasons: internal conflicts
of the staff, poor motivation, etc. Main results for each intervention are shown in the
table:
Conclusions: Using this methodology, a successful implementation of EBM
measures is possible in the vast majority of centers and yields significant
improvement in the delivery of psychosocial care. Funded by the Italian Ministry of
Health and the Lombardia Region
Disclosure: All authors have declared no conflicts of interest.
1463P EVALUATION OF SEXUALITY, QUALITY-OF-LIFE AND
DEPRESSION IN ADVANCED CANCER PATIENTS TREATED
IN A DRUG DEVELOPMENT UNIT
M. Rouanne 1 , C. Massard 2 , A. Hollebecque 2 , V. Rousseau 3 , A. Varga 2 ,
A. Gazzah 2 , Y. Neuzillet 1 , T. Lebret 1 and J. Soria 2
1 Urology, Hôpital Foch, Suresnes, FRANCE, 2 SITEP, Institut de Cancérologie,
Villejuif, FRANCE, 3 Biostatistics, Institut Gustave Roussy, Villejuif, FRANCE
Background: The advent of molecular targeted agents (MTA) opened a new era
therapy in oncology. The objective of this study was to investigate quality of life,
depression and sexual function in patients treated in a phase I drug unit evaluating
MTA.
Patients and methods: All patients included in a phase I clinical trial at the Gustave
Roussy Institute were proposed a personal interview regarding their quality of life,
depression, and sexual function. They completed 4 self-questionnaires containing the
Medical Outcomes Study Short-Form General Health Survey (SF12), the Beck
Table: 1462PD
EBM TRAINING COURSES
(No and % of attendee,
oncologists plus nurses)
REFERRING NURSE (RN)
(No and % of
pts with a RN)
Depression Inventory (BDI-II), the International Index of Erectile Function (IIEF)
and the Female Sexual Function Index (FSFI).
Results: This is, to our knowledge, the first evaluation of quality of life, depression
and sexual function in a phase I drug unit. Sixty-three patients were evaluated at
baseline. Patients had a good mental and physical function despite their disease
progression. The response rate was 75% for sexual questionnaires. For 57% of females
and 68% of males, quality of sexual life was a subject of interest. After one month
treatment, sexual dysfunction increased especially in lubrication and pain in females
and erection in males with a statistical association of anti-angiogenic inhibitors in
males (p = 0.04).
Conclusions: Patients on MTA in phase I clinical trials had a preserved mental and
physical activity whereas their sexual activity decline in both sexes. The impact of
MTA on sexual function should be routinely assessed.
Disclosure: All authors have declared no conflicts of interest.
1464P THE DIFFERENCE IN THE SERUM LEVELS OF BDNF, IL-6,
IL-8, IL-10 AND EGF IN ONCOLOGY PATIENTS DIVIDED
ACCORDING TO THE PRESENCE OF SYMPTOMS OF
DEPRESSION
L. Holubec 1 , O. Fiala 1 , V.M. Matejka 1 , J. Podlipny 2 , J. Dreslerova 1 , J. Vrzalova 3 ,
O. Topolcan 3 , J. Finek 1 and T. Svoboda 1
1 Department of Oncology & Radiotherapy, University Hospital Pilsen, Pilsen,
CZECH REPUBLIC, 2 Department of Psychiatry, University Hospital Pilsen, Czech
Republic, Pilsen, CZECH REPUBLIC, 3 Department of Nuclear Medicine,
University Hospital Pilsen, Pilsen, CZECH REPUBLIC
Objective: To assess the differences in the serum levels of Brain-derived neurotrophic
factor (BDNF), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10) and
epidermal growth factor (EGF) in oncology patients with symptoms of depression
and in oncology patients without symptoms of depression.
Methods: We administered the following self – report questionnaires to the
hospitalized oncology patients (n = 32): Zung´s Self-Rating Depression Scale (ZSDS)
and Symptom Check List Psychiatric Rating Scale (SCL 90). We also collected blood
samples from these patients for the detection of the following factors: BDNF, IL-6,
IL-8, IL-10 and EGF. The procedures had been fully explained to all patients and
written informed consent had been obtained. The patients were divided into two
groups according to the scores in ZSDS: a group with the presence of symptoms of
depression (n = 20) and a group without the symptoms of depression (n = 12). The
differences in the levels of BDNF, interleukins and EGF between the groups were
statistically assessed by Wilcoxon rank-sum test.
Results: Oncology patients with the symptoms of depression showed significantly
lower levels of BDNF (medians 1452.3 vs 3229.0 pg/ml, p = 0.014). There were no
significant differences in the levels of IL-6, IL-8, IL-10 and EGF between the groups.
Conclusion: This result supports the hypothesis of diminished neuroplasticity in
oncology patients with the symptoms of depression as measured by the serum levels
of BDNF. This study was supported by research project MSM 0021620819.
Disclosure: All authors have declared no conflicts of interest.
1465P SLEEP DIFFICULTIES, PAIN AND STRESS IN COLORECTAL
CANCER FEMALE PATIENTS
P. Heras, V. Niarou, E. Andrikopoulos and M. Hera
Internal Medicine, General Hospital of Naflio, Athens, GREECE
Aim: This study examined sleep difficulties, pain and stress among women
undergoing surgery for colorectal cancer(CC).
Methods: Perceived distress was assessed with Perceived Stress Scale (PSS). Sleep
quailty was assessed using the Pittsburgh Sleep Quality Index (PSQI). Pain severity
and interference were assessed using the Brief Pain Inventory (BPI), while frequency
PIS (No and % of
Units with a PIS)
Annals of Oncology 23 (Supplement 9): ix474–ix477, 2012
doi:10.1093/annonc/mds413
USE OF THE QPL
(No and % of pts who
receive the QPL)
PSYCHO-SOCIAL
EVALUATION (No and % of
screened patients)
Pre-Implementation 0/598 (0%) 0% 4/29 (17%) 0% 0%
Post-Implementation 557/598 (93%) 262/305 (86%) 24/29 (83%) 223/305 (73%) 253/305 (83%)
© European Society for Medical Oncology 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology.
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