Psychosocial Care Set as Standard in Cancer Treatment: IOM's Report Reflects 'Attitudinal Shift.'

Article excerpt

WASHINGTON -- An Institute of Medicine report says providing appropriate psychosocial services to all cancer patients and their families should become a new standard of care, Dr. Jimmie C. Holland said at the annual Community Oncology conference.

The report, called "Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs," recommends specific actions that health care providers, health plans, policy makers, and other stakeholders should take to achieve that goal.

"When the IOM comes out with a report, everybody listens: the government, the private sector, the policy makers. So, getting this opportunity was quite a plus," said Dr. Holland, a psychiatrist at Memorial Sloan-Kettering Cancer Center, New York, who served on the multidisciplinary IOM committee that wrote the recommendations.

Providers are called upon to identify a patient's psychosocial needs at the initial visit, link the patient with any needed psychosocial services, and incorporate that aspect of care as an integral part of the overall treatment plan. "This is the standard now on the books," noted Dr. Holland, who is credited with founding the field of "psychiatric oncology."

The report cites specific psychosocial needs that cancer patients might have. For example, if the need is coping with emotions surrounding the illness and treatment, the report recommends peer support groups, counseling/psychotherapy, and pharmcologic management of symptoms.

Another psychosocial need cited is "behavioral change to minimize disease impact." The available health service that might be appropriate in that case would be smoking cessation help or patient education.

Providing such services doesn't require major expense or shifts in practice, she said. Patients can fill out brief psychosocial distress screening questionnaires in the waiting room, for example, and be provided with resources such as the American Oncology Society American Psychosocial Oncology Society's Helpline, a national number that assists patients and families in finding a counselor in their community (866-276-7443). The American Cancer Society's Web site also provides local resources (www.cancer.org). "It doesn't take new staff or money. It's more of an attitudinal shift," Dr. Holland said.

The report, released last fall, also advises the National Cancer Institute, the Centers for Medicare and Medicaid Services, and the Agency for Healthcare Research and Quality to conduct large-scale demonstration projects and evaluation of approaches to psychosocial care in various settings and populations. Those three entities also are asked to fund research focused on the development of performance measures to assess the quality of psychosocial cancer care. …