Meeting with a medical physicist reduces patients' radiation treatment-related stress

Meeting with a medical physicist reduces patients' radiation treatment-related stress

Meeting with a medical physicist who can explain how to plan and deliver radiation therapy reduces patient anxiety and increases patient satisfaction throughout the treatment process, according to a new study published today in the International Journal of Radiation Oncology • Biology • Physics. Results from the randomized, prospective Phase III clinical trial will also be presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting.

This study is a wake-up call for medical physicists that there are new ways we can add value to patient care. It illustrates how care teams can work more effectively with patients when making their treatment decisions and managing the radiotherapy process.”

Todd F. Atwood, PhD, lead author of the study, associate professor and senior associate division director of transformational clinical physics, University of California, San Diego

Medical physicists work with radiation oncologists to ensure complex treatment plans are tailored to each patient. They also develop and manage quality control programs to ensure treatments are delivered safely, including conducting safety tests on the equipment used in a patient's treatment.

The new findings suggest that medical physicists can also complement patient education and potentially improve treatment outcomes by reducing patients' treatment-related stress. “Patients increasingly want to be more involved in their care,” said Dr. Atwood. "They're looking for more information. They usually start by searching online, but what they find is either non-specific or just too complex. They have unanswered questions that often lead to confusion, stress and anxiety."

Previous studies have shown that patient-related stress can negatively impact outcomes after radiation therapy. Dr. Atwood and his colleagues hope this approach can also contribute to better outcomes for patients by reducing stress and anxiety related to their treatment.

In this study, researchers randomized 66 patients who wanted external beam radiation therapy into two treatment arms: one who would receive Physics Direct Patient Care (PDPC) before - and during - radiation treatment, and one who would not receive PDPC radiation therapy. The patients had various types of primary cancer, most commonly breast, gynecological or prostate cancer, and most were receiving radiation therapy for the first time.

In addition to traditional care, in which patients discuss their treatment only with their radiation oncologist, the PDPC group received two pre-treatment consultations with a medical physicist who explained the technical aspects of their care — how the treatment is planned and delivered, how the radiation therapy technology works and "everything that will help keep them safe during treatment," Dr. Atwood. The medical physicist remained the patient's point of contact if additional questions arose at any point during the treatment process.

Prior to interacting with patients, the five medical physicists participating in the study completed a patient communication training program that included radiation oncology-specific lectures, role-play exercises, simulated patient interactions and analysis, and supervised physician-patient consultations that included analysis of these interactions.

Changes in treatment-related anxiety, overall satisfaction with treatment, and satisfaction with their understanding of technical aspects of care were measured over the course of treatment using patient questionnaires.

Patients who received medical physicist consultations had significant improvements in anxiety and both satisfaction metrics compared to patients who received treatment without the additional consultations. Anxiety did not differ between groups at baseline or after the simulation appointment, but was on average lower in patients who consulted the doctor after the first treatment (30.2 vs. 37.6, on a 60-point inventory, p = 0.027). However, at the end of treatment, the difference in average anxiety scores was no longer significant.

To further examine differences in anxiety between groups, researchers specifically looked at the number of patients who reported high levels of anxiety during treatment. While there were no significant differences in the proportion of patients with high anxiety at baseline, after the simulation appointment, or after the first treatment, a significant difference occurred at the end of treatment (12.5% ​​vs. 38.9% reported high anxiety, p=0.047).

While the consultations were generally beneficial for patients, Dr. Atwood said they could be particularly useful for patients who are more prone to anxiety. Among those who received the additional consultations, the percentage of patients reporting high levels of anxiety fell by more than half over the course of treatment, from 31.3% to 12.5%.

The biggest difference between groups was how satisfied patients were with their understanding of the technical aspects of their care. While there was no difference between groups at baseline, the group that received additional counseling at the simulation appointment immediately demonstrated greater satisfaction with their technical understanding of care (6.2 vs. 5.1 on a 7-point scale, p = 0.005). Technical satisfaction scores increased throughout treatment for both groups but remained significantly higher for patients who received additional consultations, reaching 6.6 out of seven for this group compared to 5.5 for the standard care group (p = 0.002).

Overall satisfaction was also significantly higher after the first treatment in patients who received physical consultation (6.7 vs. 6.0 on a 7-point scale, p = 0.014). While satisfaction increased in both groups after the first treatment, it remained significantly higher in the counseling group until the end of treatment (6.9 vs. 6.2, p=0.001).

Dr. Atwood said he was curious to see how long the benefits of the supplemental consultation would last. “It has a lasting effect,” he says. “We have believed for years that medical physics consultants have great potential, but now we have a clearer understanding of how they positively impact the patient experience.”

While other members of the care team could also be brought in to give patients a deeper understanding of their care, Dr. Atwood said he believes medical physicists are uniquely suited to the role because they are so familiar with the science that drives the technology used.

"People don't realize how personalized this therapy actually is. Medical physicists work behind the scenes to ensure this personalized treatment is both safe and effective. Our study shows that there can also be a patient-centered role that allows medical physicists to add value to the patient experience," he said.

Source:

American Society for Radiation Oncology

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