Guiding Lay Navigation in Geriatric Patients With Cancer Using a Distress Assessment Tool.

Rocque GB1, Taylor RA1, Acemgil A1, Li X2, Pisu M1, Kenzik K2, Jackson BE2, Halilova KI2, Demark-Wahnefried W2, Meneses K1, Li Y1, Martin MY2, Chambless C2, Lisovicz N1, Fouad M1, Partridge EE2, Kvale EA1; Patient Care Connect Group.

Abstract

BACKGROUND:

There is growing interest in psychosocial care and evaluating distress in patients with cancer. As of 2015, the Commission on Cancer requires cancer centers to screen patients for distress, but the optimal approach to implementation remains unclear.

METHODS:

We assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014.

RESULTS:

Of the 5,121 patients enrolled in our lay patient navigation program, 4,520 (88%) completed at least one assessment using a standardized distress tool (DT). Navigators used the tool to structure both formal and informal distress assessments. Of all patients, 24% reported distress scores of 4 or greater and 5.5% reported distress scores of 8 or greater. The most common sources of distress at initial assessment were pain, balance/mobility difficulties, and fatigue. Minority patients reported similar sources of distress as the overall program population, with increased relative distress related to logistical issues, such as transportation and financial/insurance questions. Patients were more likely to ask for help with questions about insurance/financial needs (79%), transportation (76%), and knowledge deficits about diet/nutrition (76%) and diagnosis (66%) when these items contributed to distress.