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Cancer patients with an adjustment disorder

 

Background
Every year more than 100,000 patients are diagnosed with cancer in the Netherlands. There is convincing empirical evidence that cancer patients have to deal with psychological and social sequelae related to cancer and its treatment, both during treatment and at (long-term) follow-up. Psychological problems involve symptoms related to anxiety and depression, but also problems with adjustment to cancer and its sequelae. In case of severe and persistent problems with adjustment to cancer, a DSM adjustment disorder can be diagnosed (Diagnostic and Statistical Manual of Mental Disorders). The prevalence of adjustment disorder among cancer patients has been estimated to be 19.4%. However, other studies reported prevalence rates of 5.8% to 16.9%. In case of an adjustment disorder a psychological intervention is needful.

 

Objectives
The prevalence of adjustment disorders among cancer (ex)patients has been reported to be high. Although a large amount of studies have shown evidence for the effectiveness of psychological interventions targeting cancer patients, so far, no study focused on the (cost-)effectiveness of psychological interventions targeting cancer patients with an adjustment disorder. In order to facilitate the discussion on reimbursement of psychological treatment in Dutch mental healthcare for cancer patients with an adjustment disorder, more evidence is needed. Therefore, this study aims to provide insight into the reach, the effectiveness, cost-utility and budget impact of psychological interventions targeting cancer patients with an adjustment disorder.


Method

Study design:
This study consist of two parts. Part 1 is an observational study among a representative group of cancer patients after treatment to assess the prevalence of an adjustment disorder as well as the need for psychological treatment. In Part 2, patients diagnosed with an adjustment disorder are invited to participate in a randomized controlled trial (RCT) to measure the effectiveness and cost-utility of the psychological intervention. Assessments will take place at baseline and at 3 and 6 months follow-up.

Study population:
Inclusion criteria are cancer survivors diagnosed with cancer (all types and stages, except non-melanoma skin cancer) before July 2018, finished primary cancer treatment with curative or palliative intent (all treatment modalities, except for endocrine therapy in breast/prostate cancer) and being aged ≥18 years. There will be no exclusion criteria. Patients of part 1 who are diagnosed with an adjustment disorder will be invited for part 2.

Intervention:
According to the national guideline “Adjustment Disorder”, the psychological intervention consists of three modules: a module for diagnosis and psycho-education (4 sessions, all patients) and two additional modules comprising of various types of psychological interventions (maximum of 6 sessions per module, tailored to the individual patient).

Sample size calculation:
To demonstrate an effect size of 5 point, 77 participants in each condition are needed in part 2 (power 80%, significance level 5%). Anticipating a drop-out rate of 25% between baseline measurement and follow-up at 6 months, 103 participants per condition will be included at baseline.

Instruments:
In part 1 the reach of the intervention will be investigated by diagnosing patients on whether or not to have an adjustment disorder in two steps:

  1. screening with questionnaires (distress thermometer, problem list and HADS)
  2. a diagnostic interview by a psychologist, psychotherapist or psychiatrist registered in the NVPO expert file, when a patient shows an increased risk on having an adjustment disorder.

In part 2 the effectiveness, cost-utility and budget impact of the tailored psychological treatment will be investigated. The primary outcome measure is psychological stress (HADS). Secondary outcome measures are quality of life (EORTC-QLQ-C30), adaptability to cancer (MAC), quality of life (EQ-5D-5L) and costs (iPCQ and iMCQ)


Collaboration
This project is a collaboration between the VU Amsterdam, Radboudumc and the Netherlands Comprehensive Cancer Center (IKNL).

 

Staff
Prof. dr. I.M. Verdonck - de Leeuw, Department of Otolaryngology–Head and Neck Surgery, VU University Medical Center, Amsterdam,
Prof. dr. JB Prins, Department of Medical Psychology, Radboud University Medical Center, Nijmegen
Dr. F. Jansen, Department of Clinical Psychology, VU, Amsterdam
Dr. J.A.E Custers, Department of Medical Psychology, Radboud University Medical Center, Nijmegen
F.E. van Beek MSc, Department of Clinical Psychology, VU, Amsterdam
L.M.A Wijnhoven Radbound MSc, Department of Medical Psychology, Radboud University Medical Center, Nijmegen


Permission METC

 

Funding

ZonMw

 

Questions?
For questions please contact:      
Florie van Beek MSc, junior researcher on this project
E-mail: florie.van.beek@vu.nl
And
Prof. dr. I.M. Verdonck-de Leeuw
E-mail: s.biemans@vumc.nl
 

naar boven ↑

News flashes

 

PhD thesis Mirjam de Vries

March 22, 2019 Mirjam de Vries will defend her thesis “Physicians‘ defence mechanisms during communication with advanced cancer patients”. 

 

PhD thesis Joeri Kalter

September 28, 2018 Joeri Kalter defended his thesis “Exercise and psychosocial interventions to improve quality of life in patients with cancer”. 

 

PhD thesis Sanne Duman-Lubberding

July 4, 2018 Sanne Duman-Lubberding defended her thesis "Online Patient Reported Outcome Measures to faciltate supportive care in Head and Neck Cancer patients".

 

PhD thesis Femke Jansen

January 15, 2018  Femke Jansen defended her thesis “Supportive care in head and neck cancer patients. Patient-reported needs and costs”. 
 

PhD thesis Janneke Rood

September 11, 2017 Janneke Rood defended her thesis "Perceived need for information and treatment decision-making in patients with hematological malignancies: not "one size fits all".

 

Amsterdam Public Health project

Within the context of the alliance VUmc-AMC Prof dr Ellen Laan (AMC) and prof dr Irma Verdonck-de Leeuw (VUmc) received a grant for the project "Sexual well-being in head and neck cancer patients".

 

Treatment of psychological distress in patients with head and neck or lung cancer cost-effective.
A recent study of PhD-student Femke Jansen and colleagues, recently published in the Journal of Clinical Oncology

 

PhD thesis Nadine Köhle

December 15, 2016 Nadine Köhle defended her PhD thesis "Hold on, for each other. Supporting partners of cancer patients via eHealth and positive psychology". 

 

PhD thesis Anne-Marie Krebber

December 2, 2016 Anne-Marie Krebber defended her PhD thesis "Stepped care targeting psychological distress in head and neck cancer and lung cancer patients".

 

PhD thesis Nadia van der Spek

September 7, 2016, Nadia van der Spek defended her PhD thesis "Meaning-centered group psychotherapy for cancer survivors: development, efficacy, and cost-utility". 

 

EORTC QLG Newsletter Spring 2016
The EORTC QLG  Spring Meeting took place on April 20th and 21th 2016 in Oslo. The Spring newsletter of the EORTC QLG is now available. 

PhD thesis Ingrid Cnossen

April 12, 2016, Ingrid Cnossen defended her PhD thesis entiteld “Self-management Supporting Rehabilitation in Head and Neck Cancer Patients”. 

 

VU/VUmc and Red-kite sign agreement for the provision of the Oncokompas in healthcare.

The VU University Amsterdam and VUmc Cancer Center Amsterdam work with Red-kite, distributor of software for hospitals in Netherlands. (November 3, 2015)

 

PhD thesis Christine van Gogh

December 4, 2015, Christine van Gogh defended her PhD thesis entiteld “Functional outcome of early glottic cancer”. 

Book presentation

On June 15th, 2015, Irma Verdonck presented the book "In Tune Without Cords" (in Dutch: VerderZonderStembanden) to Rob Burdorf, the president of the patient society for patients after laryngectomy.

 

PhD thesis Florien Boele

May 11 Florien Boele defended her PhD thesis, entitled "Towards improving health-related quality of life in glioma patients and their informal caregvers".

 

PhD thesis Trille Kristina Kjaer

May 8, Trille Kjaer will defend her PhD thesis entitled "Late effects after treatment of head and neck cancer and use of patient reported outcomes in clinical practice." Irma Verdonck is member of the committee.

 

Niels Stensen Fellowship
Florien Boele has received a Niels Stensen Fellowship. This is a scholarship that is awarded annually to a number of outstanding researchers who have recently obtained their PhD degree, to gain working experience abroad. Florien Boele will go to Pittsburgh (United States) and Edinburgh (Scotland) in 2015 and 2016.
 

Key paper

The publication “Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments” of A.M.H. Krebber et.al is chosen by the Editors as one of the key papers in Psycho-oncology, (issue June 2014).

 

On April 10th, 2014, the first edition of the Value Based Healthcare Prize took place. The prize for the most exceptional initiative in collaborations went to Jippa, a collaborative by VUmc, CZ, Radboud UMC and Tilburg University.

 

In November 2013 the NVPO organised the International Congress "Innovation in Psycho-Oncology". The researchgroup held several presentations and posters.

 

Interested in oncological care chain? Come 2 October 2013 to the 3rd MuON symposium in hospital Gelderse Vallei. Keynote speaker Michel van Schaik (Director Rabobank) about Innovation in the care!

 

12 april 2013: KWF Kankerbestrijding / Alpe d’HuZes has granted the research proposal Netherlands Quality of life and Biomedical Cohort Studies in Cancer (NET-QUBIC).

Marieke de Bruijn will defend her PhD thesis on 10 juni 2013 at 15.45 pm.

Support our bicycle team for Alpe d'HuZes 2013!

On 6 June 2013 our team living together with cancer will cycle the Alpe d'HuZes! This in the fight against cancer. At this moment there is already more than 1500 euro donated. Do you support us too?

 

The 15th World Congress of Psycho-Oncology and Psychosocial Academy will be held in Rotterdam, 4-8 November 2013. www.ipos-society.org/ipos2013/.

 

29 January 2013. Pink Ribbon has granted a project to develop and evaluate an online training for cancer patients with insomnia (Annemieke van Straten), and a project to develop and evaluate a breast cancer module for the OncoKompas (Nelly van Uden).

 

Charity Symposium "Living with cancer"

On December 19, 2012 there will be a Symposium ''Living with Cancer''. This is a charity symposium on meaning centered psychotherapy for cancer patients. Read more about it at the tab News at the left.

 

15 November 2012: Hoe?Zo! Radio interview with Irma Verdonck on stress and cancer.

 

October 2012: Interview with Irma Verdonck in Psychologie Magazine.

 

September 9, 2012. Interview Hans van Willigenburg with Irma Verdonck on Radio 5.

 

August 2012. Five students finish their MSc thesis and graduate as MSc in Clinical PSychology.

 

June 28-30, 2012: International symposium on Supportive Care in Cancer (MASCC ISOO) at New York. Kevin Yap and Irma Verdonck organise a workshop on e-health and supportive care.

 

Record for Alpe d'HuZes 2012. The sponsor action Alpe d'HuZes (6 and 7 June) 2012 has already yielded the record amount of 28.5 million euros.

 

June 6-8, 2012: Our research group contributes to Alpe d'HuZes as volunteers.

 

April 20, 2012: Nelly van Uden will give a presentation about OncoKompas at a conference about  ICT in health care in Barcelona.

 

March 16, 2012: NVPO congress in Utrecht, we contribute with 2 oral and 2 poster presentations and a workshop.

 

January 1, 2012: The project POLARIS project has officially started.

 

December 22, 2011: Radio program DeGids.fm, Felix Meurders interviews Corien Eeltink on sexuality and cancer. 

 

November 2, 2011: KWF / Alpe d'HuZes funds a grant for the development and evaluation of an online intervention for informal caregivers of cancer patients.

 

October 30, 2011 In the national television program "Gesprek op 2", Daphne Bunskoek interviewed Irma Verdonck on living with cancer.

 

October 28, 2011: www.oncokompas.nl is online!

 

October 23, 2011: Alpe d'HuZes hands over more than 20 million euros to the Dutch Cancer Society!

 

 

Team work

Our research projects are embedded in the two largest research institutes of VU University in Amsterdam: VUmc CCA-VICI (Cancer Center Amsterdam) www.vumc.nl/afdelingen/CCA-V-ICI/ and EMGO+ (Institute for Health and Care Research emgo.nl

We work closely with patients and their caregivers and with researchers and physicians at VU University and VU University Medical Center in Amsterdam and other research institutes and hospitals in the Netherlands and worldwide. Team work is crucial  improving research and translating results into clinical practice.

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