Implementation of a pre-treatment readiness tool for soft tissue and bone sarcoma.

Abstract

e24072 Background: There is limited data on assessing a patient’s social needs prior to starting treatment, specifically in sarcoma. There is an extensive process for bone marrow transplant preparation prior to the actual stem cell transplant given that the treatment requires patient and caregiver commitment1. For childhood cancer survivors there are some studies on assessing barriers in the transition from pediatric to adult care2. Although some sarcoma patients will face this transition and have an assessment of their physical and mental health needs prior to establishing with a new physician, this same principle of pre-treatment planning does not formally exist in other oncology care. Our hypothesis is implementation of the pre-treatment readiness tool improves outcomes in patients receiving systemic treatment for sarcoma. Methods: The Pre-Treatment Readiness Tool is a non-validated tool created in partnership with the OSU sarcoma social work team that assesses four domains of health: practical, family support, emotional and health care with a total of 24 psychosocial fields assessed, utilizing a 3-point Likert scale (no concerns at all, somewhat concerned, greatly concerned). We implemented the tool from January 1, 2018 through December 31, 2019. Clinical demographic data and the number and type of referrals made to ancillary services (e.g, housing, counseling) were collected. Data analyses performed were descriptive, correlation and cox hazard ratios: overall survival (OS) and progression-free survival (PFS). Results: There were 109 patients that completed the pre-treatment readiness tool. Most patients were older than age 40 (72.2%) and the majority were advanced stage 4 disease (50%). There were 7 of the 24 psychosocial fields that significantly impacted younger patients (Table). The older the patient, the more concerns were reported and subsequently more referrals were ordered. This was not associated with gender or stage. Notably patients of any age with Stage 4 disease who reported emotional concerns were associated with a poor OS (p = 0.030). Conclusions: The implementation of a pre-treatment readiness tool identified important concerns amongst patients prior to starting chemotherapy, with emotional concerns associated with poor survival. This data needs to be further validated against a control group and prospectively to improve addressing patient needs during treatment for sarcoma. Concerns for younger patients (cutoff age 40). Values p values Finances 0.027 Employment/School 0.000 Fear/Worries 0.001 Child Care 0.004 Nervousness/Anxiety 0.009 Ability to have children 0.000 Alcohol/Recreational Use 0.016