A medical physicist’s consultation with a patient can help reduce anxiety and increase satisfaction with radiation care

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Meeting with a medical physicist who can explain how planned and administered radiation therapy reduces patient anxiety and increases patient satisfaction throughout treatment, according to a New research published today in the journal International Journal of Radiation Oncology, Biology, Physics. Results of the prospective, randomized phase III clinical trial will also be presented at the American Society of Radiation Oncology (ASTRO) Annual Meeting.

“This study is a wake-up call to medical physicists that there are new ways we can add value to patient care,” said Dr. Todd F. Atwood, lead author of the study Researcher, who is also an associate professor and senior vice president of the department. Director of Transformative Clinical Physics at the University of California, San Diego. “It illustrates how care teams can more effectively collaborate with patients as they perform treatment decision and directing radiation therapy. “

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

The new findings suggest that medical physicists can also supplement patient education and potentially improve patient outcomes by reducing patients’ treatment-related stress. “Patients increasingly want to be more involved in their care,” says Dr. Atwood. “They’re looking for more information. Usually, they start by searching online, but what they find isn’t specific or too complicated. They have unanswered questions, which often lead to confusion. confusion, stress and worry. “

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

For this study, researchers randomly assigned 66 patients seeking external beam radiation therapy into two treatment groups: one that would receive Physical Direct Patient Care (PDPC) before – and during throughout – radiation treatment, and one group did not receive PDPC radiation. Patients had different primary cancers, most commonly breast cancer, gynecological cancer, or prostate cancer, and most received radiation therapy for the first time.

In addition to traditional care, in which patients only discuss their treatment with a radiation oncologist, the PDPC team received two pre-treatment consultations with a medical physicist, who explain the technical aspects of their care — how treatment is planned and delivered, how radiotherapy The technology works, and “everything that goes in keeps them safe during treatment,” says Dr Atwood. The medical physicist remains a resource for patients should additional questions arise at any point during treatment.

Prior to interacting with patients, the five medical physicists involved in the study completed a training program in patient communication that included: radiation Specific oncology lectures, role-playing exercises, simulated patient interactions and analyzes, and supervised physician-patient consultations including analysis of such interactions .

Changes in treatment-related anxiety, overall satisfaction with treatment, and satisfaction with their understanding of technical aspects of care measured during treatment using a patient questionnaire reporting person.

Patients who received a medical physicist’s consultation had significant improvements in both anxiety and satisfaction scores, compared with patients who received no further advice. Anxiety did not differ between groups at baseline or after the interview appointment, but on average it was lower for patients consulted by a physiotherapist after the first treatment (30.2 vs. 37.6, on the 60-point inventory, p = 0.027). However, at the end of treatment, the difference in mean anxiety scores was no longer significant.

To take a closer look at the differences in anxiety levels between the groups, the researchers looked specifically at the number of patients who reported high levels of anxiety during treatment. Although there was no significant difference in the proportion of patients with high anxiety at baseline, after the interview appointment or after the first treatment, a significant difference appeared at the end of the treatment course (12). .5% versus 38.9% reported high anxiety, p = 0.047).

While the tips are beneficial to patients in general, Dr Atwood said they can be especially helpful for patients prone to anxiety. Among those who received further counseling, during treatment, the proportion of patients reporting high levels of anxiety was more than halved, from 31.3% to 12.5%.

The biggest difference between the groups was the level of patient satisfaction with their understanding of the technical aspects of their care. Although there was no difference between groups at baseline, the group that received additional counseling at the simulated appointment immediately expressed greater satisfaction with their technical understanding of care (6.2). versus 5.1 on a 7-point scale, p = 0.005). Technical satisfaction scores increased for both groups over the course of treatment, but they were still significantly higher for patients who received further counseling, reaching 6.6 out of seven for that group, compared with 5 ,5 for the standard care group (p = 0.002).

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

Dr Atwood said he was pleased to see how long the benefits of additional counseling could last. “It has a lasting impact,” he said. “We thought medical physics advisors had great potential for many years, but now we have a better understanding of how they positively impact the patient experience.”

While other members of the care team may also be called upon to provide patients with a deeper understanding of their care, Dr Atwood said he believes medical physicists completely fit for this role because they are familiar with the science that drives the technology used. .

“People don’t realize how real this personalized therapy really is. Medical physicists work behind the scenes to make sure this personalized treatment is both safe and effective. Study Ours indicate that there may also be a patient-facing role that will allow medical physicists to add value to the patient experience,” he said.

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