Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2003

Open Access 01-12-2003 | Review

Benefits of psychosocial oncology care: Improved quality of life and medical cost offset

Authors: Linda E Carlson, Barry D Bultz

Published in: Health and Quality of Life Outcomes | Issue 1/2003

Login to get access

Abstract

The burden of cancer in the worldwide context continues to grow, with an increasing number of new cases and deaths each year. A significant proportion of cancer patients at all stages of the disease trajectory will suffer social, emotional and psychological distress as a result of cancer diagnosis and treatment. Psychosocial interventions have proven efficacious for helping patients and families confront the many issues that arise during this difficult time. This paper reviews the literature detailing the extent of distress in patients, the staffing needed to treat such levels of distress, and the efficacy of psychosocial treatments for cancer patients. This is followed by a summary of the literature on medical cost offset in mental health, other medical populations, and in cancer patients, which supports the notion that psychosocial interventions are not only effective, but also economical. Conclusions support taking a whole-person approach, as advocated by a growing number of health care professionals, which would not only help to treat the emotional and social aspects of living with cancer, but also provide considerable long-term cost savings to overburdened health-care systems.
Literature
1.
Ferlay J, Bray F, Pisani P, Parkin DM: GLOBOCAN 2000: Cancer Incidence, Mortality and Prevalence Worldwide, Version 1.0 Lyon, France: IARC Press 2002.
2.
Sellick SM, Crooks DL: Depression and cancer: An appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psycho-Oncology 1999, 8: 315–333.PubMedCrossRef
3.
Massie MJ, Popkin MK: Depressive Disorders. In Psycho-oncology (Edited by: New York: Oxford University Press). Holland J 1998, 518–540.
4.
Noyes R, Holt CS, Massie MJ: Anxiety Disorders. In Psycho-oncology (Edited by: Holland JF). New York: Oxford University Press 1998, 548–563.
5.
Strain JJ: Adjustment Disorders. In Psycho-oncology (Edited by: Holland JF). New York: Oxford University Press 1998, 509–517.
6.
Derogatis LR, Morrow GR, Fetting J: The prevalence of psychiatric disorders among cancer patients. JAMA 1983, 249: 751–757.PubMedCrossRef
7.
DeFlorio M, Masie MJ: Review of depression in cancer: gender differences. Depression 1995, 3: 66–80.CrossRef
8.
Carlson LE, Bultz BD, Angen M, Cullum J, Goodey E, Koopmans J, et al.: High Levels of Untreated Distress in Cancer Patients 2003.
9.
Zabora JR, Blanchard CG, Smith ED, Roberts CS, Glajchen M, Sharp JW, et al.: Prevalence of psychological distress among cancer patients across the disease continuum. Journal of Psychosocial Oncology 1997, 15: 73–87.CrossRef
10.
Isikhan V, Guner P, Komurcu S, Ozet A, Arpaci F, Ozturk B: The relationship between disease features and quality of life in patients with cancer-I. Cancer Nurs 2001, 24: 490–495.PubMedCrossRef
11.
Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S: The prevalence of psychological distress by cancer site. Psychooncology 2001, 10: 19–28.PubMedCrossRef
12.
Kugaya A, Akechi T, Okuyama T, Nakano T, Mikami I, Okamura H, et al.: Prevalence, predictive factors, and screening for psychologic distress in patients with newly diagnosed head and neck cancer. Cancer 2000, 88: 2817–2823.PubMedCrossRef
13.
Wenzel LB, Fairclough DL, Brady MJ, Cella D, Garrett KM, Kluhsman BC, et al.: Age-related differences in the quality of life of breast carcinoma patients after treatment. Cancer 1999, 86: 1768–1774.PubMedCrossRef
14.
Moore K: Out-of-pocket expenditures of outpatients receiving chemotherapy. Oncol Nurs Forum 1998, 25: 1615–1622.PubMed
15.
16.
Hounshell JF, Tomori CF, Newlin RF, Knox KF, Rundhaugen LF, Tallman MF, et al.: Changes in finances, insurance, employment, and lifestyle among persons diagnosed with hairy cell leukemia. Oncologist 2001, 6: 435–440.PubMedCrossRef
17.
Zabora J, BrintzenhofeSzoc K, Jacobsen P, Curbow B, Piantadosi S, Hooker C, et al.: A new psychosocial screening instrument for use with cancer patients. Psychosomatics 2001, 42: 241–246.PubMedCrossRef
18.
Zabora JR, Blanchard CG, Smith ED, Roberts CS, Glajchen M, Sharp JW, et al.: Prevalence of psychological distress among cancer patients across the disease continuum. Journal of Psychosocial Oncology 1997, 15: 73–87.CrossRef
19.
Zabora JR, Smith-Wilson R, Fetting JH, Enterline JP: An efficient method for psychosocial screening of cancer patients. Psychosomatics 1990, 31: 192–196.PubMedCrossRef
20.
Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC: Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer 1998, 82: 1904–1908.PubMedCrossRef
21.
Cull A, Gould A, House A, Smith A, Strong V, Velikova G, et al.: Validating automated screening for psychological distress by means of computer touchscreens for use in routine oncology practice. Br J Cancer 2001, 85: 1842–1849.PubMedCentralPubMedCrossRef
22.
Allenby A, Matthews J, Beresford J, McLachlan SA: The application of computer touch-screen technology in screening for psychosocial distress in an ambulatory oncology setting. Eur J Cancer Care (Engl) 2002, 11: 245–253.CrossRef
23.
Carlson LE, Speca M, Hagen N, Taenzer P: Computerized quality-of-life screening in a cancer pain clinic. J Palliat Care 2001, 17: 46–52.PubMed
24.
Andersen B: Psychological interventions for cancer patients to enhance the quality of life. Journal of Consulting and Clinical Psychology 1992, 60: 552–568.PubMedCentralPubMedCrossRef
25.
Trijsburg RW, van Knippenberg FC, Rijpma SE: Effects of psychological treatment on cancer patients: a critical review. Psychosom Med 1992, 54: 489–517.PubMedCrossRef
26.
Cunningham AJ: Group psychological therapy for cancer patients. A brief discussion of indications for its use, and the range of interventions available. Support Care Cancer 1995, 3: 244–247.PubMed
27.
Fawzy FI, Fawzy NW, Arndt LA, Pasnau RO: Critical review of psychosocial interventions in cancer care. Archives of General Psychiatry 1995, 52: 100–113.PubMedCrossRef
28.
Meyer TJ, Mark MM: Effects of psychosocial interventions with adult cancer patients: A meta-analysis of randomized experiments. Health Psychology 1995, 14: 101–108.PubMedCrossRef
29.
Greer S: Improving quality of life: adjuvant psychological therapy for patients with cancer. Support Care Cancer 1995, 3: 248–251.PubMed
30.
Bottomley A: Group cognitive behavioural therapy interventions with cancer patients: a review of the literature. European Journal of Cancer Care (English Language Edition) 1996, 5: 143–146.CrossRef
31.
Iacovino V, Reesor K: Literature on interventions to address cancer patients' psychosocial needs: What does it tell us? Journal of Psychosocial Oncology 1997, 15: 47–71.CrossRef
32.
Bottomley A: Where are we now? Evaluating two decades of group interventions with adult cancer patients. Journal of Psychiatric & Mental Health Nursing 1997, 4: 251–265.CrossRef
33.
Fobair P: Cancer support groups and group therapies: Part I. Historical and theoretical background and research on effectiveness. Journal of Psychosocial Oncology 1997, 15: 63–81.CrossRef
34.
Fawzy FI, Fawzy NW, Canada AL: Psychosocial treatment of cancer: an update. Current Opinion in Psychiatry 1998, 11: 601–605.CrossRef
35.
Fawzy FI: Psychosocial interventions for patients with cancer: what works and what doesn't. Eur J Cancer 1999, 35: 1559–1564.PubMedCrossRef
36.
Blake-Mortimer J, Gore-Felton C, Kimerling R, Turner-Cobb JM, Spiegel D: Improving the quality and quantity of life among patients with cancer: a review of the effectiveness of group psychotherapy. Eur J Cancer 1999, 35: 1581–1586.PubMedCrossRef
37.
Cunningham AJ: Adjuvant psychological therapy for cancer patients: putting it on the same footing as adjunctive medical therapies. Psychooncology 2000, 9: 367–371.PubMedCrossRef
38.
Schneiderman N, Antoni MH, Saab PG, Ironson G: Health psychology: psychosocial and biobehavioral aspects of chronic disease management. Annu Rev Psychol 2001, 52: 555–580.PubMedCrossRef
39.
Newell SA, Sanson-Fisher RW, Savolainen NJ: Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst 2002, 94: 558–584.PubMedCrossRef
40.
Fawzy FI: A short-term psychoeducational intervention for patients newly diagnosed with cancer. Support Care Cancer 1995, 3: 235–238.PubMed
41.
Sloman R, Brown P, Aldama E, Chu E: The use of relaxation for the promotion of comfort and pain relief in persons with advanced cancer. Contemporary Nurse 1994, 3: 6–12.PubMedCrossRef
42.
Goodwin PJ, Leszcz M, Koopmans J, Arnold A, Doll R, Chochinov H, et al.: Randomized trial of group psychosocial support in metastatic breast cancer: the BEST study. Breast-Expressive Supportive Therapy study. Cancer Treatment Reviews 1996, 22: Suppl-6.CrossRef
43.
Leszcz M, Goodwin PJ: The rationale and foundations of group psychotherapy for women with metastatic breast cancer. International Journal of Group Psychotherapy 1998, 48: 245–273.PubMed
44.
Richardson MA, Post-White J, Grimm EA, Moye LA, Singletary SE, Justice B: Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment. Alternative Therapies in Health and Medicine 1997, 3: 62–70.PubMed
45.
Dobkin PL, Da Costa D: Group psychotherapy for medical patients. Psychology, Health & Medicine 2000, 5: 87–96.CrossRef
46.
Cunningham AJ, Edmonds CV: Group psychological therapy for cancer patients: a point of view, and discussion of the hierarchy of options. Int J Psychiatry Med 1996, 26: 51–82.PubMedCrossRef
47.
Classen C, Butler LD, Koopman C, Miller E, DiMiceli S, Giese-Davis J, et al.: Supportive-expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial. Arch Gen Psychiatry 2001, 58: 494–501.PubMedCrossRef
48.
Spiegel D, Morrow GR, Classen C, Raubertas R, Stott PB, Mudaliar N, et al.: Group psychotherapy for recently diagnosed breast cancer patients: a multicenter feasibility study. Psychooncology 1999, 8: 482–493.PubMedCrossRef
49.
Carlson LE, Ursuliak Z, Goodey E, Angen M, Speca M: The Effects of a Mindfulness Meditation Based Stress Reduction Program on Mood and Symptoms of Stress in Cancer Outpatients: Six Month Follow-Up. Support Care Cancer 2001, 9: 112–123.PubMedCrossRef
50.
Speca M, Carlson LE, Goodey E, Angen M: A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med 2000, 62: 613–622.PubMedCrossRef
51.
Cunningham AJ, Tocco EK: A randomized trial of group psychoeducational therapy for cancer patients. Patient Care and Counseling 1989, 14: 101–114.CrossRef
52.
Cunningham AJ, Edmonds CV, Jenkins G, Lockwood GA: A randomised comparison of two forms of a brief, group, psychoeducational program for cancer patients: weekly sessions versus a "weekend intensive". Int J Psychiatry Med 1995, 25: 173–189.PubMedCrossRef
53.
Cunningham AJ, Edmonds VI, Hampson AW, Hanson H, Hovenac M, Jenkins G, et al.: A group psychoeducational program to help cancer patients cope with and combat their disease. Advances 1991, 7: 41–56.
54.
Canadian Association of Psychosocial Oncology: Standards: Canadian association of psychosocial oncology. Canadian Association of Psychosocial Oncology 1999.
55.
Hargreaves WA, Shumway M, Hu TW: Measuring psychotherapy costs and effectiveness. In Cost-effectiveness of psychotherapy (Edited by: Miller NE, Magruder KM). New York: Oxford University Press 1999, 85–98.
56.
Greenberg PE, Stiglin LE, Finkelstein SN, Berndt ER: The economic burden of depression in 1990. Journal of Clnical Psychiatry 1993, 54: 405–418.
57.
Brown G, Harris T: Social origins of depression: A study of psychiatric disorder in women. New York: The Free Press 1978.
58.
Howland RH: Chronic depression. Hosp Community Psychiatry 1993, 44: 633–639.PubMed
59.
Weissman MM, Myers JK, Thompson WD: Depression and its treatment in a US urban community 1975–1976. Arch Gen Psychiatry 1981, 39: 417–421.CrossRef
60.
Widmer RB, Cadoret RJ: Depression in primary care: Changes in pattern of patient visits and complaints during a developing depression. Family Practice 1978, 7: 293–302.
61.
Katon W, Berg A, Robins A, Risse S: Depression: Patterns of medical utilization and somatization in primary care. In Illness Behaviour: A Multidisciplinary Model (Edited by: McHugh S, Vallis TM). New York: Plenum 1986, 335–364.
62.
Howland RH: General health, health care utilization, and medical comorbidity in dysthymia. Int J Psychiatry Med 1993, 23: 211–238.PubMedCrossRef
63.
Lechnyr R: The cost savings of mental health services. EAP Digest 1993., 22:
64.
Borgquist L, Hansson L, Lindelow G, Nettlebladt L: Perceived health and high consumers of care: A study of mental health problems in a Swedish health care district. Psychological Medicine 1993, 23: 770.CrossRef
65.
Lane JS: Medical cost offset: A eview of current research and practices. Preferred Mental Health Management. 1998.
66.
Sobel DS: The cost-effectiveness of mind-body medicine interventions. Prog Brain Res 2000, 122: 393–412.PubMedCrossRef
67.
Cummings NA, VandenBos GR: The twenty years Kaiser-Permanente experience with psychotherapy and medical utilization: implication for national health policy and national health insurance. Health Policy Quarterly 1981, 1: 159–175.PubMed
68.
Guthrie E, Moorey J, Margison F, Barker H, Palmer S, McGrath G, et al.: Cost-effectiveness of brief psychodynamic-interpersonal therapy in high utilizers of psychiatric services. Arch Gen Psychiatry 1999, 56: 519–526.PubMedCrossRef
69.
Pallak MS, Cummings NA, Dorken H, Henke CJ: Medical costs, Medicaid, and managed mental health treatment: the Hawaii study. Manag Care Q 1994, 2: 64–70.PubMed
70.
Mumford E, Schlesinger HJ, Glass GV, Patrick C, Cuerdon T: A new look at evidence about reduced cost of medical utilization following mental health treatment. Am J Psychiatry 1984, 141: 1145–1158.PubMedCrossRef
71.
de Boer AG, Sprangers MA, Bartelsman JF, de Haes HC: Predictors of health care utilization in patients with inflammatory bowel disease: a longitudinal study. Eur J Gastroenterol Hepatol 1998, 10: 783–789.PubMedCrossRef
72.
Jensen MP, Turner JA, Romano JM: Correlates of improvement in multidisciplinary treatment of chronic pain. J Consult Clin Psychol 1994, 62: 172–179.PubMedCrossRef
73.
Chiles JA, Lambert MJ, Hatch AL: The impact of psychological interventions on medical cost offset: A meta-analytic review. Clinical Psychology: Science and Pratice 1999, 6: 204–220.
74.
Lorig KR, Mazonson PD, Holman HR: Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum 1993, 36: 439–446.PubMedCrossRef
75.
Lorig KR, Sobel DS, Stewart AL, Brown BW Jr, Bandura A, Ritter P, et al.: Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care 1999, 37: 5–14.PubMedCrossRef
76.
Middaugh SJ, Levin RB, Kee WG, Barchiesi FD, Roberts JM: Chronic pain: its treatment in geriatric and younger patients. Arch Phys Med Rehabil 1988, 69: 1021–1026.PubMed
77.
Caudill M, Schnable R, Zuttermeister P, Benson H, Friedman R: Decreased clinic use by chronic pain patients: response to behavioral medicine intervention. Clin J Pain 1991, 7: 305–310.PubMedCrossRef
78.
Blumenthal JA, Jiang W, Babyak MA, Krantz DS, Frid DJ, Coleman RE, et al.: Stress management and exercise training in cardiac patients with myocardial ischemia. Effects on prognosis and evaluation of mechanisms. Arch Intern Med 1997, 157: 2213–2223.PubMedCrossRef
79.
Linden W, Stossel C, Maurice J: Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med 1996, 156: 745–752.PubMedCrossRef
80.
Simpson JSA, Carlson LE, Trew M: Impact of a Group Psychosocial Intervention on Health Care Utilization by Breast Cancer Patients. Cancer Practice 2001, 9: 19–26.PubMedCrossRef
81.
Ashbury FD, Findlay H, Reynolds B, McKerracher K: A Canadian survey of cancer patients' experiences: Are their needs being met? Journal of Pain and Symptom Management 1998, 16: 298–306.PubMedCrossRef
82.
Rosenberg HJ, Rosenberg SD, Ernstoff MS, Wolford GL, Amdur RJ, Elshamy MR, et al.: Expressive disclosure and health outcomes in a prostate cancer population. Int J Psychiatry Med 2002, 32: 37–53.PubMedCrossRef
83.
84.
Pennebaker JW: Putting stress into words: health, linguistic, and therapeutic implications. Behav Res Ther 1993, 31: 539–548.PubMedCrossRef
Metadata
Title
Benefits of psychosocial oncology care: Improved quality of life and medical cost offset
Authors
Linda E Carlson
Barry D Bultz
Publication date
01-12-2003
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2003
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-1-8

Other articles of this Issue 1/2003

Health and Quality of Life Outcomes 1/2003 Go to the issue

Review

International versions of the Menopause Rating Scale (MRS)

Review

Impact of Nausea and Vomiting on Quality of Life in Cancer Patients During Chemotherapy

Review

The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications

Research

Evaluation of the Functional Assessment of Cancer Therapy-General (FACT-G) Spanish Version 4 in South America: Classic Psychometric and Item Response Theory Analyses

Commentary

Clinical and Outcome Research in oncology The need for integration

Research

Quality of Life in rural and urban populations in Lebanon using SF-36 Health Survey