Supportive Oncology: A Collaborative Approach to Improved Cancer Care
Thursday, April 12, 2018
When a serious disease or illness arises, treating the condition is just one aspect of caring for the patient. By identifying and treating the psychosocial, social, and spiritual issues related to a disease — what is called “supportive care” — providers are able to better connect with patients and work to deliver better outcomes.
“Once I become aware of a patient's concerns, it allows us to try to help them — whether it's transportation, paying for medication, treating anxiety/depression, or something else,” Dr. Lawrence Feldman, a medical oncologist at UI Health, wrote in an article, “Supportive Oncology—A Collaborative & Multidisciplinary Approach,” recently published in Oncology Times.
Dr. Feldman is among 135 physicians from 25 Chicago-area cancer institutions, that make up the Supportive Oncology Collaborative (SOC), a Coleman Foundation initiative that works to improve supportive care services for cancer patients through designing and testing process improvements, creating screening tools and training, and advocating with payers to cover supportive care services.
The SOC has a goal of improving the care and quality of life for cancer patients. The collaborative members have created tools and resources for clinicians, including:
- Supportive oncology distress and survivorship screening tools
- Nearly 100 follow-up care documents
- More than 25 CME credit-eligible training modules hosted on the National Comprehensive Cancer Network (NCCN)
- A referral network of resources to use for patients
- Members have worked together to create practice models, tools, and resources, which are being implemented and actively monitored and evaluated across several institutions
Supportive Oncology at UI Health
At the University of Illinois Cancer Center, providers started using the SOC Supportive Oncology Screening Tool about two years ago in the Lung and Head & Neck Cancer Clinics. The screening tool consists of 35 questions and is adapted from several evidence-based screening tools that members of the SOC reviewed. During a patient's first visit — and at specified points during their treatment — patients fill out the screening tool, and members of the care team review the responses.
“The screening tool identifies the psychological, social, and spiritual issues related to the patient's disease, which can profoundly impact how well a patient responds to, complies with, and benefits from medical treatment,” Feldman writes. “Practicing supportive care requires our team to take time to learn the patient's concerns and create a comfortable space to discuss them.”
Patients are screened for distress across several categories, such as pain and side effects, sleeplessness and fatigue, financial concerns, transportation, childcare, psychological distress, anxiety, depression, spiritual needs, and other barriers they may have following their treatment plan.
“As a result of the SOC, our institution was able to see that more staff were needed,” said Feldman. “While I always thought that we did a good job of explaining to the patient their illness and treatment protocols, I was surprised to learn that over half of my patients answered that they wanted to better understand their disease, treatment, stage, or prognosis or wanted help discussing their treatment options with their families. It made me realize that just because I explained things, it does not mean my patients are able to hear it and process it at that time.”
Among other highlights of the Supportive Oncology program:
- Mary Pasquinelli, an advanced practice nurse, presented a poster at the 2017 Chicago Multidisciplinary Symposium in Thoracic Oncology detailing how the SOC screening tools build awareness for the importance of supportive care among patients and providers. Pasquinelli was instrumental in the development and implementation of evidence-based screening tools within the University of Illinois Cancer Center, and through her leadership, the screening tools have been adapted to help identify early brain and lung metastasis and to take into account varying levels of patient health literacy.
- Social worker Ana Gordon also played a vital role in the early-stage pilot of SOC screening tools, providing mentoring and coaching to social workers across Chicago-area institutions and developing the business case for investing in the employment of social workers.
- As a co-creator of the latest supportive oncology tools and resources, the cancer care teams at UI Health a have unlimited access to their use. A number of UI Health leaders — including Eileen Knightly, Heather Schuster, Dr. Kent Hoskins, Khari Reed, Marisa Carpinelli, Dr. Nilofer Kidiwala, Dr. Oana Danciu, and Zane Deliu — have been integral to the work and success of the SOC.