Phase 2 pilot study of Pathfinders: a psychosocial intervention for cancer patients.
OBJECTIVE
Pathfinders is a multi-faceted psychosocial care program for cancer patients; it was developed in community oncology and adapted to the academic oncology setting. This prospective, single-arm, phase 2 pilot study examined the acceptability and feasibility of Pathfinders for women with metastatic breast cancer.


METHODS
Over 3 months, participants completed patient-reported surveys including the Patient Care Monitor (PCM, review of systems), Functional Assessment of Chronic Illness Therapy-Breast Cancer (FACT-B), Self Efficacy, and a single-item survey asking patients whether the program was helpful to them. A technology-based data collection system was used to capture electronic patient-reported outcomes at point of care, report symptoms in real time to clinicians, and collect warehouse data to provide a detailed longitudinal picture of the patient experience when receiving Pathfinders.


RESULTS
Participants (n = 50) were: mean age 51 (SD 11); 76% white, 20% black; 74% married; 50% college degree. Forty-two (n = 42) patients completed baseline and 3-month assessments. Statistically significant improvements (all P < 0.05) occurred in PCM subscales for Distress (mean [SE] = -3.42 [1.21]), Despair (-4.53 [1.56]), and Quality of Life (2.88 [0.97]), and the FACT-B Emotional Wellbeing subscale (2.07 [0.46]). Of the 29 participants asked if Pathfinders was helpful, 27 (93%) responded positively and two did not respond. Other instruments measuring symptoms, quality of life, and self-efficacy showed improvement.


CONCLUSIONS
In a phase 2 pilot study, Pathfinders was helpful to patients and is feasible in an academic medical center. Follow-up data collected at the 3-month assessment suggest that the program impacts various psychological outcomes, notably distress and despair.
Division of Medical Oncology, Department of Medicine, Duke University Medical Center (DUMC), Durham, NC 27710, USA. amy.abernethy@duke.edu
Amy P
AP
Abernethy
James E
JE
Herndon
April
A
Coan
Tina
T
Staley
Jane L
JL
Wheeler
Krista
K
Rowe
Sophia K
SK
Smith
H
H
Shaw
H Kim
HK
Lyerly
D000203:Activities of Daily Living; D001008:Anxiety Disorders / Q000209:etiology / Q000517:prevention & control*; D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology* / Q000628:therapy; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D008960:Models, Psychological; D019964:Mood Disorders / Q000209:etiology / Q000517:prevention & control*; D009362:Neoplasm Metastasis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011788:Quality of Life; D012944:Social Support; D029181:Spirituality