title: Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy.
abstract: OBJECTIVE
  Professionally administered psychosocial interventions have been shown to improve the quality of life of cancer patients undergoing chemotherapy. The present study sought to improve access to psychosocial interventions during chemotherapy treatment by evaluating the efficacy and costs of a patient self-administered form of stress management training that requires limited professional time or experience to deliver.
  
  
  METHODS
  Four hundred eleven patients about to start chemotherapy were randomly assigned to receive usual psychosocial care only, a professionally administered form of stress management training, or a patient self-administered form of stress management training. Quality-of-life assessments were conducted before randomization and before the second, third, and fourth treatment cycles. Intervention costs were estimated from both payer and societal perspectives.
  
  
  RESULTS
  Compared with patients who received usual care only, patients receiving the self-administered intervention reported significantly (P < or = .05) better physical functioning, greater vitality, fewer role limitations because of emotional problems, and better mental health. In contrast, patients who received the professionally administered intervention fared no better in terms of quality of life than patients receiving usual care only. Costs of the self-administered intervention were estimated to be 66% (from a payer perspective) to 68% (from a societal perspective) less than the average costs of professionally administered psychosocial interventions for patients starting chemotherapy.
  
  
  CONCLUSIONS
  Evidence regarding the efficacy and favorable costs of self-administered stress management training suggests that this intervention has the potential to greatly improve patient access to psychosocial intervention during chemotherapy treatment.
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute and University of South Florida, Tampa, FL 33612, USA. jacobsen@moffitt.usf.edu
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Meade
authors.forename: Kevin D
authors.initials: KD
authors.lastname: Stein
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Chirikos
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
authors.forename: John C
authors.initials: JC
authors.lastname: Ruckdeschel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life; D012064:Relaxation Therapy / Q000191:economics*; D012648:Self Care; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome