Pin-pointing service characteristics associated with implementation of evidence-based distress screening and management in australian cancer services: data from a crosssectional study

Aim: Standardized screening and structured management of psychosocial distress can improve cancer patients’ social functioning, treatment adherence, symptom burden, and length of life. However, there are limited studies that identify service characteristics associated with evidence-based screening practices. This cross-sectional study aimed to categorize cancer services in accordance to their distress screening and referral pathway procedures and identify potential characteristics associated with different stages of implementing distress management. The article reflects on the progress made toward achieving comprehensive and equitable supportive care in Australian cancer services. Methods: A total of 221 Australian cancer service representatives were approached to complete online cross-sectional surveys. An implemented evidence-based screening and referral pathway was defined as process where all outpatients are screened and rescreened using a validated screening tool with referrals generated by health professionals with an established referral model. The service was classified as partial implementation if only some processes were met. Goodness of fit tests were conducted to determine any association between implementation phase and service characteristics. Results: Of 221 services, 110 representatives completed items related to distress screening pathways (45%). Only 8 (7%) services reported complete implementation, 80 (73%) reported partial implementation, and 22 (20%) reported not screening. Of the 8 complete implementation services, 6 (75%) had evaluated the pathway effectiveness and uptake. Compared to nonscreening services, reporting complete or partial implementation pathways was significantly associated with public funding (P = .002) and teaching services (P = .003). There was no significant association with the service being located in an urban or rural setting (P = .6) or whether mental health services were available within the setting (P = .07). Conclusion and clinical implications: Australian services are making progress toward achieving comprehensive supportive care. However, further work is required to ensure all services are providing optimal distress screening practices and ensuring all patients have equitable access to supportive care. These data can provide insight to service-specific assistance required to improve distress management processes with the overarching goal to provide equitable and comprehensive supportive care.