This study, called CARES, examines the impact of an integrated screening and stepped collaborative care intervention on patients, family caregivers, and economic outcomes in oncology settings in the USA through a randomized phase 3 trial.
The study titled "Patient, family caregiver, and economic outcomes of an integrated screening and novel stepped collaborative care intervention in the oncology setting in the USA (CARES)" published on March 12, 2024, presents the findings of a randomized, parallel, phase 3 trial conducted in 29 oncology outpatient clinics associated with the UPMC Hillman Cancer Center in the USA. The aim was to compare the efficacy of an integrated screening and novel stepped collaborative care intervention with the standard of care for patients with cancer experiencing symptoms like depression, pain, or fatigue. The trial enrolled 459 patients and 190 family caregivers, with patients being randomly assigned to stepped collaborative care or standard of care.
The stepped collaborative care intervention involved cognitive-behavioral therapy (CBT) delivered by a care coordinator via telemedicine, with the option of pharmacotherapy if needed. The primary outcome measured was health-related quality of life at 6 months, with maintenance of treatment benefits assessed at 12 months. The results showed that patients in the stepped collaborative care group had a significant improvement in health-related quality of life compared to the standard-of-care group at 6 months, with this improvement maintained at 12 months. Patients in the stepped collaborative care group also showed greater improvements in emotional, functional, and physical well-being.
The study highlighted the importance of integrated screening and evidence-based stepped approaches to treatment in the oncology setting. The findings indicated that the collaborative care intervention was effective in improving patient health-related quality of life, reducing symptoms, and enhancing emotional, functional, and physical well-being. Additionally, the intervention showed cost-saving benefits, with the stepped collaborative care group having lower activity-based costs compared to the standard-of-care group.
Furthermore, the study addressed limitations of previous trials by enrolling a large sample size, using evidence-based treatments, and incorporating telemedicine for accessibility. The findings suggested that the integrated screening and treatment approach could be a valuable component of value-based care models and have the potential to improve outcomes for patients diagnosed with cancer.
In conclusion, the integrated screening and novel stepped collaborative care intervention demonstrated efficacy in improving health-related quality of life, reducing symptoms, and providing cost savings in the oncology setting. The findings have implications for shifting the practice of screening and treatment paradigms to enhance patient-centered outcomes in cancer care.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00015-1/fulltext
The stepped collaborative care intervention involved cognitive-behavioral therapy (CBT) delivered by a care coordinator via telemedicine, with the option of pharmacotherapy if needed. The primary outcome measured was health-related quality of life at 6 months, with maintenance of treatment benefits assessed at 12 months. The results showed that patients in the stepped collaborative care group had a significant improvement in health-related quality of life compared to the standard-of-care group at 6 months, with this improvement maintained at 12 months. Patients in the stepped collaborative care group also showed greater improvements in emotional, functional, and physical well-being.
The study highlighted the importance of integrated screening and evidence-based stepped approaches to treatment in the oncology setting. The findings indicated that the collaborative care intervention was effective in improving patient health-related quality of life, reducing symptoms, and enhancing emotional, functional, and physical well-being. Additionally, the intervention showed cost-saving benefits, with the stepped collaborative care group having lower activity-based costs compared to the standard-of-care group.
Furthermore, the study addressed limitations of previous trials by enrolling a large sample size, using evidence-based treatments, and incorporating telemedicine for accessibility. The findings suggested that the integrated screening and treatment approach could be a valuable component of value-based care models and have the potential to improve outcomes for patients diagnosed with cancer.
In conclusion, the integrated screening and novel stepped collaborative care intervention demonstrated efficacy in improving health-related quality of life, reducing symptoms, and providing cost savings in the oncology setting. The findings have implications for shifting the practice of screening and treatment paradigms to enhance patient-centered outcomes in cancer care.
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00015-1/fulltext
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