Onyx 360 Program Shown to Reduce Patient Distress

VBCC - February 2015, ASH 2014 Highlights - Multiple Myeloma
Kate Smith

San Francisco, CA—Patients with multiple myeloma express a high level of “distress,” which providers and counselors can evaluate and manage, according to a report from the Cancer Support Community (CSC), Washington, DC.

At ASH 2014, Victoria Kennedy, LCSW, and colleagues described the Onyx 360 program, which uses a very brief distress screening measure, ad­ministered by telephone, to identify patients with psychosocial distress. The program then provides patient access to psychosocial care and results in a meaningful reduction in distress, Ms Kennedy said.

An analysis of distress before and after access to Onyx 360 showed high uptake of support services offered through the program and a significant reduction in patients’ and their caregivers’ level of distress.

Distress screening at pivotal points along the disease continuum can identify problems before a crisis event occurs, can allow patients to voice concerns and gain information, and can improve the use of healthcare resources, the investigators noted.

“We know that up to 40% of patients experience significant levels of distress, but fewer than 10% actually use psychosocial supportive services, often because they lack awareness of or access to them,” Ms Kennedy noted.

Although distress screening has been promoted by many cancer organizations, surveys show that only 50% of patients treated at academic centers, and substantially fewer in nonacademic centers, report being asked about distress, she added.

Onyx 360 Program

CSC provides evidence-based support programs for patients and their families. CSC collaborated with Onyx Pharmaceuticals to be part of its integrated patient assistance program, which screens and refers patients and caregivers for psychosocial services. Unlike standard patient assistance (reimbursement) programs, the goal of Onyx 360 ­­is to deliver integrated biopsychosocial care with reimbursement assistance.

Patients who contacted Onyx 360 were asked distress-screening questions by an oncology nurse during an initial phone call, and their answers translated into a distress level rating. Patients were given the opportunity to request support services, including reimbursement and clinical support, transportation assistance, and real-time referrals to key resources.

Consenting patients and caregivers were transferred to CSC, whose mental health professionals further assessed them and offered free counseling and resource referral, group support, and treatment decision-making counseling. Patients were then rescreened 30 days after their initial call.

Success of the Program

A total of 151 patients were evaluated for changes in their levels of distress between the initial and follow-up calls. Distress levels significantly diminished for the 90% of patients who engaged with the resources and services within Onyx 360, Ms Kennedy reported.

“This decrease was greatest in patients who initially had the highest levels of distress,” she said.

During the follow-up call, 82% of patients reported lower levels of distress for at least 1 screening question. For at least 1 question, 56% of patients reported a subsequent level of distress that ­­was at least 3 levels below their initial ­­distress on a scale of 0 to 10. Among patients who had initially reported a high level of distress, the mean stress level was reduced by ­2.6 levels.

The study showed that the percentage of patients reporting a high level of distress decreased over time, from 47% to 29% at follow-up.

Setting a New Industry Standard

The researchers noted that integrated distress screening, referral, and follow-up represent a new industry standard for patient access programs. It improves psychosocial outcomes and overall satisfaction in patients with advanced myeloma.

The researchers hope to learn whether patients who are able to reduce their distress level will be more adherent to treatment, and whether this will increase value to the patient and to the healthcare system. n

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Last modified: February 26, 2015
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