Distress screening, intervention, and follow-up outcomes among Hispanic and Caucasian women with newly diagnosed breast cancer.

Abstract

163 Background: We describe acceptance and impact of mental health (MH) interventions provided to an English speaking Caucasian and Spanish speaking Hispanic female breast cancer (BC) population reporting symptoms of depression and anxiety. Methods: Records of 170 women with newly diagnosed BC at Cancer Centers of Colorado at SCL Health/Saint Joseph Hospital in 2015 were retrospectively assessed for record of a distress screening questionnaire (DSQ), administered in each patients’ native language. Among patients who reported psychosocial distress (PD), records were reviewed for an outreach phone call and visit with social work (SW) or MH, new antidepressant or anxiolytic prescription, and completion of a second DSQ. SCL Health IRB approval obtained. Results: Of 170 subjects, 94 (68% (n = 64) Caucasian, 19% (n = 18) Hispanic, 13% (n = 12) other) completed an initial DSQ. Scores reflecting PD were seen in 57 DSQs; 15 were high-grade PD (HPD). Nearly half (49%; n = 28) of those with PD had been called by MH or SW; 93% (n = 14) with HPD were called. Anxiety scores (AS) improved in 78% (n = 18) and depression scores (DS) in 74% (n = 17) of subjects called. AS and DS improved in 67% (n = 8) and 75% (n = 9), respectively, of Caucasian patients and in 89% (n = 8) and 67% (n = 6) of Hispanic patients called. Of 35 patients who completed follow-up DSQ, 17 visited with MH or SW. AS and DS improved in 65% (n = 11) of these. Improved AS and DS were seen in 38% (n = 3) and 63% (n = 5) of Caucasian patients, respectively, and 88% (n = 7) and 63% (n = 5) of Hispanic patients who had a visit. An antidepressant or anxiolytic was prescribed for 7 patients; AS and DS improved for 33% (n = 1) of Caucasian patients and 67% (n = 2) of Hispanic patients given prescriptions. Conclusions: Outreach to patients with PD and HPD correlated with improved AS and DS. Hispanics were more likely than Caucasians to accept a visit from MH or SW and were more likely to improve AS and DS following a visit with these services or antidepressant or anxiolytic prescription, demonstrating the importance of intervention in this group. This study does not account for patients’ initial staging, progression or regression, therapy pursued, nor presence of other psychosocial concern.