Oncologist Recommendation Matters! - Predictors of Psycho-Oncological Service Uptake in Oncology Outpatients.

OBJECTIVE: Highly distressed cancer patients often do not use psycho-oncological services (POS). Research on predictors of POS uptake has mainly focused on patient-related variables and less on communication variables, so we examined the link between patient-oncologist communication (i.e., talking about psychosocial distress, providing detailed information, and recommending POS) and POS uptake.

METHODS: We conducted a prospective, observational study in an Oncology Outpatient Clinic in Switzerland. Predictors (i.e., patient-related variables and patient's reports of the patient-oncologist communication) were assessed via semi-structured interviews and information on outpatient POS uptake was prospectively assessed. For statistical analysis a multivariate logistic regression was performed.

RESULTS: Of 333 participants (mean age 61 years; 55% male; 54% Distress Thermometer ≥5), 77 (23%) had used POS during a 4-month period. Patients who reported an oncologist recommended POS (odds ratio [OR])=6.27, 95% confidence interval [CI]=3.14-12.85) and those who were not sure if they had received a recommendation (OR=4.64, 95% CI=1.83-11.97) were more likely to attend POS than those who reported receiving no recommendation. Talking about psychosocial distress (OR=0.74, 95% CI=0.38-1.46) and providing detailed information about POS did not predict POS uptake (OR=1.06, 95% CI=0.46-2.38).

CONCLUSIONS: Oncologists' expert recommendations to attend POS were strongly associated with patients' uptake of POS. The central role played by oncologists should be accounted for in stepped psycho-oncological care when POS referral pathways are defined.