Abstract
12 Background: For new cancer patients, information about the complexity of the disease, treatment schedule and potential side effects is often delivered during an emotional, stressful visit which can lead to misunderstanding. Appropriate informational support can improve informed decision making, adherence to treatment, and reduce anxiety and cancer morbidity. This is a 3-part clinical study investigating the utility of a patient-centered individualized care plan for patients with gastrointestinal (GI) cancer starting a new treatment. Methods: Part 1: Items identified in a comprehensive literature search were formatted into a questionnaire. For each item, participants ranked its importance. Part 2: MDs and RNs involved in the care of patients with GI cancer provided comments about the content of the care plan. Part 3: A prospective cohort study was conducted. During the first 10-weeks, patients received the standard of care. During the subsequent 10-weeks, patients received the intervention, a written individualized care plan. Outcomes were assessed at baseline and 2-4 weeks: QOL (FACT-G), anxiety and depression (HADS), treatment compliance and patient satisfaction (FACT-TS-PS). Results: Part 1: 73 items were included in the questionnaire. 20 patients completed the interview. Part 2: A long and short version of the care plan were created. The majority of MDs and RNs preferred the long version. Based on the comments, the final version was created. Part 3: 54 and 41 patients have been enrolled in the control and intervention cohorts, respectively. Analysis of the baseline data revealed fewer self-reported anxious (p=0.008) and depressive symptoms (p=0.002) in the intervention group. The nursing satisfaction score was significantly higher in the intervention group (7.09 vs. 4.80, p=0.018). Overall QOL and satisfaction scores were higher in the intervention group, but not statistically significant (81.30 vs. 76.25, 79.70 vs. 76.27). Conclusions: The care plan resulted in fewer anxious and depressive symptoms. There was a trend towards improved QOL and satisfaction in the intervention group, although not significant. We are continuing to enroll patients and analyze follow-up data.
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