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  • Abstractvortrag | Abstract talk
  • V082

Psychosoziales Screening mittels direkter Begfragung im Arzt-Patienten-Gespräch vs. Fragebogen - eine Cluster-randomsierte kontrollierte Studie

Referral to psychosocial services via integrated psychosocial screening compared to questionnaires in adult patients with high-grade glioma: a cluster randomized controlled trial

Mirjam Renovanz
Tübingen

Appointment

Date:
Time: –
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Location / Stream:
Runder Saal

Session

Neuroonkologie 5

Topic

  • Neuroonkologie

Authors

Mirjam Renovanz (Tübingen), Melina Hippler (Tübingen), Robert Kuchen (Mainz), Lorenz Dörner (Tübingen), David Rieger (Tübingen), Joachim P. Steinbach (Frankfurt), Michael W. Ronellenfitsch (Frankfurt), Almuth Kessler (Würzburg), Martin Misch (Berlin), Julia Onken (Berlin), Marion Rapp (Düsseldorf), Minou Nadji-Ohl (Stuttgart), Marcus Mehlitz (Trier), Jürgen Meixensberger (Leipzig), Michael Karl Fehrenbach (Leipzig), Naureen Keric (Mainz), Florian Ringel (Mainz), Jan Coburger (Ulm), Carolin Weiß Lucas (Köln), Jens Wehinger (Ludwigsburg), Friederike Schmidt-Graf (München), Jens Gempt (München), Marcos Tatagiba (Tübingen), Ghazaleh Tabatabai (Tübingen), Melanie Schranz (Mainz), Susanne Singer (Mainz)

Abstract

Patients diagnosed with high-grade gliomas (HGG) suffer from significant distress. Due to neurological and neurocognitive deficits its assessment remains challenging. We evaluated face-to-face assessment during doctor-patient consultations (DPC) regarding impact on referral to psychosocial services and effects of DPC on patients" emotional well-being.

In a cluster-randomized study across 13 German centers, the intervention group (IG) underwent screening via three structured questions (SQ) during DPC, while the control group (CG) completed a questionnaire (Distress Thermometer). Emotional functioning (EF) was measured using the EORTC Quality of Life Questionnaire (EORTC QLQ-C30), with poor EF defined as a score ≤71 (score 0-100, higher scores indicating higher function). Specialized psychosocial care (PC) utilization was assessed at follow-up, and mixed-model logistic regression was used to evaluate outcomes. Associations between SQ responses and EF scores were also analyzed.

Of 763 patients enrolled, 506 completed follow-up. Emotional functioning was poor in 59.7%, both in the IG (168/281) and in the CG (134/225). No gender-specific differences occurred.

PC utilization rates were similar (IG: 55.4%, CG: 64.9%; OR=0.67, 95% CI=0.40-1.11, p=0.115). DPC duration was comparable between groups (IG mean=23.06 min, SD=9.16 vs. CG mean=23.04 min, SD=14.63). Most patients (71%) reported feeling relieved after the consultation, no significant difference between IG and CG (Fisher"s exact test, p=0.322). A relationship emerged between positive SQ responses and lower EF scores: none positive (n=39, EF median=91.7), one positive (n=70, EF median=75.0), two positive (n=113, EF median=58.3), and three positive (n=121, EF median=50.0).

Face-to-face distress screening during DPCs resulted in similar psychosocial service referrals to questionnaire-based assessments. However, patients responding positively to any SQ item should be considered at clinically relevant risk, warranting further psychosocial evaluation and support.