title: Structural distress screening and supportive care for patients with lung cancer on systemic therapy: A randomised controlled trial.
abstract: Gaining regular insight into the nature and severity of distress by a psychosocial nurse coupled with referral to psychosocial and/or paramedical healthcare provider(s) is an experimental supportive care approach. We sought to examine the effects of this approach on quality of life (QoL), patient's mood and satisfaction, end-of-life care and survival in patients with lung cancer.
  
  
  
  Patients with newly diagnosed or recurrent lung cancer starting systemic therapy were randomly assigned to receive usual care or the experimental approach. Patients were followed up at 1, 7, 13 and 25 weeks after randomisation with the EORTC-QLQ-C30, the European Quality of Life-5D, the Hospital Anxiety and Depression Scale and the Patient Satisfaction Questionnaire-III. Primary outcome was the mean change in the EORTC-QLQ-C30 global QoL-score between 1 and 25 weeks.
  
  
  
  A total of 223 patients were randomised of whom 111 (50%) completed all four assessments (44% in the usual care group versus 55% in the experimental group). No significant difference was found in the mean change global QoL-score (-2.4, 95% CI: 12.1-7.2; P = 0.61), nor in the other patient-reported outcomes. Fewer patients in the experimental group received chemotherapy shortly before the end-of-life, and median survival was comparable (10.3 versus 10.1 months, P = 0.62). Of the 112 dropouts, 33 died and 79 discontinued participation for other reasons.
  
  
  
  This supportive care approach neither improved QoL nor other patient-reported outcomes in patients with lung cancer. However, it reduced the use of chemotherapy shortly before the end of life. Possibly, (late) side effects of systemic therapy may have obscured effects of our intervention on QoL.
  
  
  
  NTR3540.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, The Netherlands. Electronic address: o.p.geerse@umcg.nl.
authors.forename: O P
authors.initials: OP
authors.lastname: Geerse
authors.affiliation: University of Groningen, University Medical Center Groningen, Wenckebach Institute and Netherlands Comprehensive Cancer Organization (IKNL), The Netherlands.
authors.forename: J E H M
authors.initials: JE
authors.lastname: Hoekstra-Weebers
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, The Netherlands.
authors.forename: M H
authors.initials: MH
authors.lastname: Stokroos
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Epidemiology, The Netherlands.
authors.forename: J G M
authors.initials: JG
authors.lastname: Burgerhof
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, The Netherlands.
authors.forename: H J M
authors.initials: HJ
authors.lastname: Groen
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, The Netherlands.
authors.forename: H A M
authors.initials: HA
authors.lastname: Kerstjens
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, The Netherlands.
authors.forename: T J N
authors.initials: TJ
authors.lastname: Hiltermann
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000517:prevention & control; D019033:Delivery of Health Care, Integrated / Q000379:methods; D003863:Depression / Q000517:prevention & control; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000451:nursing / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011568:Psychiatric Nursing / Q000379:methods*; D011788:Quality of Life; D013315:Stress, Psychological / Q000517:prevention & control*; D011795:Surveys and Questionnaires
chemical_list: D000970:Antineoplastic Agents
keywords: Distress screening; Lung cancer; Quality of life; Supportive care; Systemic therapy