Implementation of NCCN distress management guidelines by member institutions

Learning points from paper

Two points relate to the standards of care.

• First, the  standards stipulate that mental health professionals ex-  perienced in psychosocial aspects of cancer should be  readily available to help patients. Accordingly, each  member institution should have mental health services  available for patients.
• Second, the standards also stipulate  that all patients should be screened for distress at their initial visit, at appropriate intervals, and as clinically indicated. To be consistent with this standard, each member institution should routinely screen all patients for distress.

Critique of paper

Other comments

Citation and Abstract

Source: http://www.cas.usf.edu/~jacobsen/Jacobsen%20NCCN.pdf

Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw. 2007 Jan;5(1):99-103. Jacobsen PB, Ransom S.

H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida, 12902 Magnolia Drive, Tampa, FL 33612, USA. jacobsen@moffitt.usf.edu

Up to half of all adults with cancer experience clinically significant psychological distress and much of this distress goes unrecognized and untreated. As part of an effort to improve the care of cancer patients, the National Comprehensive Cancer Network (NCCN) has developed clinical practice guidelines for distress management that include recommendations about the evaluation and treatment of distress. These authors conducted a study to evaluate the implementation of these distress management guidelines by NCCN member institutions. The NCCN member institutions that treat adults were asked in April and May 2005 to describe their distress management practices, and 15 (83%) provided responses. Of these, 8 (53%) conduct routine distress screening for at least some patient groups, with 4 additional institutions (27%) pilot-testing screening strategies. However, only 20% of surveyed member institutions screened all patients as the guidelines recommend. In addition, whether institutions that conduct routine distress screening do so through standardized assessment methods is unclear, because 37.5% of institutions that conduct screening rely only on interviews to identify distressed patients. Findings suggest that most institutions consider screening patients' mental health concerns important and worthwhile, but that greater implementation of guideline recommendations is needed.

PMID: 17239329