Oncologist recommendation matters!—Predictors of psycho‐oncological service uptake in oncology outpatients

• Published in: Psycho-oncology (Chichester, England) England), 2019-02, Vol.28 (2), p.351-357
• Main Authors: Frey Nascimento, Antje, Tondorf, Theresa, Rothschild, Sacha I., Koller, Michael T., Rochlitz, Christoph, Kiss, Alexander, Schaefert, Rainer M., Meinlschmidt, Gunther P., Hunziker, Sabina, Gaab, Jens, Zwahlen, Diana
• Format: Article
• Language: English
• Subjects: Aged; Cancer; Communication; Confidence intervals; distress; Female; Humans; Male; Medical referrals; Mental health care; Middle Aged; Neoplasms - psychology; Oncologists; Oncology; Outpatients; Patient Acceptance of Health Care - statistics & numerical data; Patient compliance; Patients; patient‐physician communication; Physician patient relationships; Physician-Patient Relations; predictors; Prospective Studies; Psychiatry; Psycho-Oncology - statistics & numerical data; Psychological distress; psychological support; Psychosocial factors; Psychosocial well being; psycho‐oncology; recommendation; Referral and Consultation - statistics & numerical data; referral pathway; Statistical analysis; stepped care; Stress, Psychological - therapy; Switzerland; Talking; Uptake; utilization; Variables
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.4948

Objective Highly distressed cancer patients often do not use psycho‐oncological services (POS). Research on predictors of POS uptake has mainly focused on patient‐related variables and less on communication variables, so we examined the link between patient‐oncologist communication (ie, talking about psychosocial distress, providing detailed information, and recommending POS) and POS uptake. Methods We conducted a prospective, observational study in an Oncology Outpatient Clinic in Switzerland. Predictors (ie, patient‐related variables and patient's reports of the patient‐oncologist communication) were assessed via semistructured interviews, and information on outpatient POS uptake was assessed after 4 months. For statistical analysis, a multivariate logistic regression was performed. Results Of 333 participants (mean age 61 years; 55% male; 54% distress thermometer ≥5), 77 (23%) had used POS during a 4‐month period. Patients who reported an oncologist‐recommended POS (odds ratio [OR] = 6.27, 95% confidence interval [CI] = 3.14‐12.85) and those who were not sure if they had received a recommendation (OR = 4.64, 95% CI = 1.83‐11.97) were more likely to attend POS than those who reported receiving no recommendation. Talking about psychosocial distress (OR = 0.74, 95% CI = 0.38‐1.46) and providing detailed information about POS did not predict POS uptake (OR = 1.06, 95% CI = 0.46‐2.38). Conclusions Oncologists' expert recommendations to attend POS were strongly associated with patients' uptake of POS. The central role played by oncologists should be accounted for in stepped psycho‐oncological care when POS referral pathways are defined.