Distress Thermometer Intervention Trial

2014-08-27 03:19:57 | BioPortfolio


The diagnosis and treatment of cancer has been shown to lead to very high levels of distress among patients. Although treatments for a range of different cancers have become much better in recent years, the distress that accompanies diagnosis and treatment can have serious negative effects for patients. Research has shown that, for a number of reasons, patients find it difficult to inform healthcare professionals about the cause of their distress whether it is physical (e.g. pain), psychological (anxiety and depression), personal partners and family) or social (finances). Also, medical staff often fail to detect even high levels of distress. This means that a great deal of distress is not being treated and this may lead to more hospital and GP visits, and dissatisfaction with care. The Distress Thermometer and Problem List (DT&PL) is a simple method of identifying distress in cancer patients using the familiar image of a thermometer. It offers patients a list of common treatment-related difficulties to help them identify any problems that cause distress. A trained staff member uses the DT&PL to discuss with the patient different options for addressing each concern: directly where possible (action taken by the patient or the staff member present) or leading to a referral to a specialist where necessary. Our research aims to measure whether the DT&PL is effective in quickly identifying and treating cancer-related distress and therefore preventing longer-term problems developing. The investigators also want to know whether patients find it helpful to complete the DT&PL and whether using the DT&PL saves NHS time and money.


BACKGROUND: Systematic psychological assessment and appropriate psychological support is a key aim of NICE guidance for supportive and palliative cancer care. Cancer causes high levels of distress during diagnosis, treatment and beyond. 'Distress' is a psychological state that may be fuelled by physical (e.g. pain), interpersonal (family tensions), psychological (anxiety and depression), social (finances), and existential concerns. Often these concerns are not expressed by patients or identified by healthcare staff. Our pilot work suggests that the Distress Thermometer and Problem List (DT&PL) is a tool that healthcare staff can use to efficiently identify and address these holistic needs. Use of the DT&PL could reduce both patient distress and the NHS costs of treating the sequelae of distress.

AIMS: To demonstrate the feasibility of performing a randomised controlled trial (RCT) in 3 cancer therapy units and to provide data for the design of a future trial in larger numbers of radiotherapy and chemotherapy units. To compare use of the Distress Thermometer and Problem List (DT&PL) with usual care and document differences in patients' psychological well-being and health-related quality of life. To assess the cost-effectiveness to the NHS and society of using the DT&PL in routine clinical practice. To assess patient and staff attitudes to completing the DT&PL and identify any perceived gaps in local psychosocial supportive services.

METHODS: A RCT to compare usual psychosocial care with usual care plus DT&PL administered by trained radiographers and nurses for cancer patients receiving chemotherapy or radiotherapy. The DT&PL will be used during and at the end of chemo/radiotherapy. Baseline questionnaires include Profile of Mood States (POMS - primary outcome), European Organisation for Research and Treatment of Cancer (EORTC) cancer-related quality of life measure and EQ-5D utility score. Qualitative interviews will explore patient, carer and staff views on the DT&PL and other aspects of supportive care. Patient follow up will occur at 1, 6 and 12 months to determine whether the intervention improves psychological well-being and health related quality of life and the impact on NHS and broader societal costs.

Study Design

Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Supportive Care




Distress Thermometer and Problems List, Usual psychosocial support


Royal United Hospital
United Kingdom




University Hospitals Bristol NHS Trust

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T03:19:57-0400

Clinical Trials [2105 Associated Clinical Trials listed on BioPortfolio]

The Effectiveness of the Screening Inventory of Psychosocial Problems (SIPP) in Cancer Patients

The purpose of this study is to evaluate the effectiveness and feasibility of the Screening Inventory of Psychosocial Problems (SIPP) in consultation settings with respect to early recogni...

Trial Comparing Active Intervention At Diagnosis With Usual Care to Improve Psycho-social Care in AYAO

Adolescents and young adults (AYA) patients experience significant distress in specific areas at diagnosis. The investigators hypothesize that providing developmentally-appropriate AYA-spe...

Psychosocial Screening for Neuroendocrine Tumor Patients

This is a psychosocial screening application to usual care in a cohort of neuroendocrine tumor patients. The application involves monitoring using the NCCN Distress Thermometer(DT), Hospit...

Northern Alberta Psychosocial Telecare (NAPT) Screening for HNC Patients

This is a randomized controlled trial comparing a web-based psychosocial screening application to usual care in a cohort of surgically-treated head and neck cancer patients to determine it...

Adolescent and Young Adult Survivor Transition

The purpose of this study is to help adolescents and young adult cancer survivors address their psycho-social needs during the transitional period. The transitional period begins at comple...

PubMed Articles [21986 Associated PubMed Articles listed on BioPortfolio]

Physical Symptom Burden and Its Association With Distress, Anxiety, and Depression in Breast Cancer.

Physical symptom burden and psychologic symptoms are highly prevalent in women with breast cancer. The Distress Thermometer and Problem List (DT&PL) is commonly used in oncology clinics to screen for ...

Prevalence of Physical Problems Detected by the Distress Thermometer and Problem List in Patients With Myeloproliferative Disorders.

Background: Patients with myeloproliferative neoplasms (MPNs) can have a severe physical symptom burden over an extended disease trajectory that contributes to decreased quality of life. Few studies, ...

The distress thermometer provides a simple screening tool for selecting distressed childhood cancer survivors.

We investigated the value of the distress thermometer, a one-item screening tool, in childhood cancer survivors.

Prevalence of Physical Problems Detected by the Distress Thermometer and Problem List in Patients with Breast Cancer.

Patients with breast cancer have high rates of physical symptoms that negatively impact their quality of life. The relationship between women's perceptions of these physical symptoms and patient demog...

Web-Based Stress Management for Newly Diagnosed Patients With Cancer (STREAM): A Randomized, Wait-List Controlled Intervention Study.

Purpose Being diagnosed with cancer causes major psychological distress; however, a majority of patients lack psychological support during this critical period. Internet interventions help patients ov...

Medical and Biotech [MESH] Definitions

Organized efforts to address ongoing psychological and social problems of individuals, their partners, families and caregivers.

A system of record keeping in which a list of the patient's problems is made and all history, physical findings, laboratory data, etc. pertinent to each problem are placed under that heading.

The World Health Organization's classification categories of health and health-related domains. The International Classification of Functioning, Disability and Health (ICF) consists of two lists: a list of body functions and structure, and a list of domains of activity and participation. The ICF also includes a list of environmental factors.

A list, criteria, or screening tool designed to improve PATIENT SAFETY by determining an individual's exposure to potentially inappropriate drugs. They are designed to prevent MEDICATION ERRORS by INAPPROPRIATE PRESCRIBING. Analysis for a list includes factors such as DOSE-RESPONSE RELATIONSHIP, DRUG; DRUG-RELATED SIDE EFFECTS AND ADVERSE REACTIONS; AGE FACTORS; GENDER; and existing medical conditions.

A performance measure for rating the ability of a person to perform usual activities, evaluating a patient's progress after a therapeutic procedure, and determining a patient's suitability for therapy. It is used most commonly in the prognosis of cancer therapy, usually after chemotherapy and customarily administered before and after therapy. It was named for Dr. David A. Karnofsky, an American specialist in cancer chemotherapy.

More From BioPortfolio on "Distress Thermometer Intervention Trial"

Quick Search


Relevant Topics

  Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...

Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, a...

An anesthesiologist (US English) or anaesthetist (British English) is a physician trained in anesthesia and perioperative medicine. Anesthesiologists are physicians who provide medical care to patients in a wide variety of (usually acute) situations. ...

Searches Linking to this Trial