A randomized trial to assess the (cost) effectiveness of the discussion of the distress thermometer by a nurse in addition to usual care for patients treated with curative intent for breast cancer

Every year about 90,000 people are diagnosed with cancer in the Netherlands.
Despite the increasing survival, cancer still has a major impact on someone's
life. Patients experience psychosocial distress after hearing diagnosis, during
treatment and if the disease relapses. The use of interventions for
cancer-related distress is important to reduce this distress. Distress has a
negative impact on the quality of life, the recovery during and after treatment
and may even adversely affect survival. There is insufficient attention to the
systematic approach to psychosocial problems in cancer patients in the
Netherlands. A task force discussed and studied which instrument measures
psychosocial problems best. The lastmeter (distress thermometer) had the best
results. A guideline is written to use the lastmeter for patients with cancer
and will be used in hospitals in the Netherlands. However, it is not clear what
the effects are of the use of the lastmeter on the psychosocial wellbeing of
the patient. Furthermore, it is also unknown whether the use of the lastmeter
leads to cost-effective care. This study focuses on breast cancer patients.
Patients with breast cancer are often relatively young, the treatment process
is lengthy and they have a long survival expectancy. Therefore, it is important
to optimize the psychosocial care so long term problems can be avoided. A
study on the application of the lastmeter for this patient group is thus of
importance. The research question is: what is the effect of discussion the
lastmeter by a nurse on the psychosocial well-being in patients treated for
primary breast cancer?

An efficiency study will be conducted to evaluate the systematic use of the
distress thermometer and its discussion by a nurse as compared to the usual
care provided to outpatients who are treated for primary breast cancer by their
treating physicians . The clinical and economic impact of the use of the
lastmeter will be assessed in comparison with usual care.

A RCT with two arms will be performed.

The intervention is to apply the distress thermometer as written in the
guideline written by 'Vereniging Integrale Kankercentra'. The distress
thermomter is collected from the experimental group and then discussed by a
trained nurse.

There is no risk associated with this study.