THURSDAY, March 28, 2024 (HealthDay News) — A stepped collaborative care intervention can improve health-related quality of life for patients with cancer and depression, pain, or fatigue, according to a study published online March 12 in The Lancet.

Jennifer L. Steel, Ph.D., from the University of Pittsburgh, and colleagues conducted a randomized phase 3 trial in 29 oncology outpatient clinics to examine the efficacy of an integrated screening and novel stepped collaborative care intervention versus standard of care among patients (aged 21 years and older) with cancer and one or more of the following symptoms: depression, pain, or fatigue. A total of 459 patients and 190 family caregivers were enrolled: 222 and 237 patients were assigned to standard of care and stepped collaborative care, respectively. Stepped collaborative care was composed of once-weekly cognitive behavioral therapy via telemedicine.

The researchers found that the zero- to six-month improvement in health-related quality of life was significantly greater for patients in the stepped collaborative care group than those in the standard-of-care group (effect size, 0.09). The stepped collaborative care group maintained health-related quality of life (effect size, 0.01). Compared with the standard-of-care group, patients in the stepped collaborative care group had significantly greater zero- to six-month improvements in emotional, functional, and physical well-being. Neither group reported adverse events; deaths were considered unrelated to the study.

“The changes in domains of health-related quality of life were significant and clinically meaningful based on the number of points by which the health-related quality of life score changed as well as the small-to-moderate effect size observed,” the authors write.

Several authors disclosed ties to the biopharmaceutical and publishing industries.

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