STRUCTURED PSYCHOSOCIAL INTERVENTION FOR FRENCH PATIENTS WITH METASTATIC CANCER IS POSSIBLE IN REAL LIFE

Abstract

Objectives There is still no structured psychosocial intervention (SPI) available in France for patients with metastatic disease. For first time in France, a structured psychosocial intervention (SPI) was proposed and studied as “proof of concept.” A novel intervention combining two evaluated and efficacious therapies (Programme Personnalisé d’Accompagnement Thérapeutique; PPACT®) was delivered in two community centers. The program evaluation aim measures pre/post changes in psychological and quality of life (QoL) outcomes. Methods Patients (N=88) with metastatic cancer seeking psychosocial care were offered PPACT which combined elements of the biobehavioral intervention 1 with Supportive Expressive Group Therapy 2 and was delivered in 32 sessions across 12 months. The sample was predominantly older (M=57 years), female (72%), and partnered (74%). Thirty one percent had metastatic breast cancer (n=27), but 16 other disease types with metastases were represented. Patients were assessed pretreatment, 6, and 12 months using the Hospital Anxiety and Depression Scale [HADS; 3 ] and EORTC Quality of Life Questionnaire-Core 30 [QoL; 4 ]. Patients were followed for 5+ years to describe survival. Results Significant changes (improvements) across time were found on the HADS anxiety and depression scales, and EORTC functioning scales and symptom items (ps<.01). Effects were replicated with the breast sample. Kaplan Meier analyses showed a 54% likelihood of survival at 5 years. Conclusions As metastatic cancer is now a chronic disease, offering PPACT in community centers achieved QoL improvements for patients and demonstrates the feasibility and clinical import of structured psychosocial support interventions for French patients.

Keywords

• biobehavioral
• cancer
• metastatic
• psychological
• supportive expressive
• survival