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01-06-2018 | Original Article

The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial

Authors: Susanne Singer, Julia Roick, Jürgen Meixensberger, Franziska Schiefke, Susanne Briest, Andreas Dietz, Kirsten Papsdorf, Joachim Mössner, Thomas Berg, Jens-Uwe Stolzenburg, Dietger Niederwieser, Annette Keller, Anette Kersting, Helge Danker

Published in: Supportive Care in Cancer | Issue 6/2018

Abstract

Purpose

We examined whether multi-disciplinary stepped psycho-social care decreases financial problems and improves return-to-work in cancer patients.

Methods

In a university hospital, wards were randomly allocated to either stepped or standard care. Stepped care comprised screening for financial problems, consultation between doctor and patient, and the provision of social service. Outcomes were financial problems at the time of discharge and return-to-work in patients < 65 years old half a year after baseline. The analysis employed mixed-effect multivariate regression modeling.

Results

Thirteen wards were randomized and 1012 patients participated (n = 570 in stepped care and n = 442 in standard care). Those who reported financial problems at baseline were less likely to have financial problems at discharge when they had received stepped care (odds ratio (OR) 0.2, 95% confidence interval (CI) 0.1, 0.7; p = 0.01). There was no evidence for an effect of stepped care on financial problems in patients without such problems at baseline (OR 1.1, CI 0.5, 2.6; p = 0.82). There were 399 patients < 65 years old who were not retired at baseline. In this group, there was no evidence for an effect of stepped care on being employed half a year after baseline (OR 0.7, CI 0.3, 2.0; p = 0.52).

Trial registration

NCT01859429

Conclusions

Financial problems can be avoided more effectively with multi-disciplinary stepped psycho-social care than with standard care in patients who have such problems.

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Title: The effects of multi-disciplinary psycho-social care on socio-economic problems in cancer patients: a cluster-randomized trial
Authors: Susanne Singer
Julia Roick
Jürgen Meixensberger
Franziska Schiefke
Susanne Briest
Andreas Dietz
Kirsten Papsdorf
Joachim Mössner
Thomas Berg
Jens-Uwe Stolzenburg
Dietger Niederwieser
Annette Keller
Anette Kersting
Helge Danker
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 6/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-4024-x

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Abstract

Purpose

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