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.
Abernethy
Amy P
AP
Division of Medical Oncology, Department of Medicine, Duke University Medical Center (DUMC), Durham, NC 27710, USA. amy.abernethy@duke.edu
Herndon
James E
JE
Coan
April
A
Staley
Tina
T
Wheeler
Jane L
JL
Rowe
Krista
K
Smith
Sophia K
SK
Shaw
H
H
Lyerly
H Kim
HK
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