Psychosocial Assessment in High-Grade Glioma: Physician-led vs Questionnaire-based Approaches

Overview

The GLIOPT trial compared physician-led psychosocial assessments integrated into consultations with questionnaire-based screening using the Distress Thermometer (DT) in adults with high-grade glioma (HGG). Results indicated that face-to-face evaluations may improve identification and support of distressed patients compared to standard questionnaire screening.

Background

High-grade gliomas (HGG) are the most common primary brain tumors with variable prognosis, often accompanied by significant neurological and psychiatric symptoms including depression and anxiety. Psychosocial support is essential to maintain quality of life, yet routine screening and care provision remain inadequate. In Germany, certified neuro-oncological centers are required to screen for psycho-oncological distress, commonly using tools like the NCCN Distress Thermometer, though these instruments may not fully address neurocognitive deficits prevalent in HGG patients. The GLIOPT trial aimed to evaluate whether integrating psychosocial screening questions into doctor-patient consultations could enhance detection and care over standard questionnaire-based methods.

Data Highlights

Key Findings

• Physician-led psychosocial assessment involved three targeted questions addressing mood, physical strain, and cognitive difficulties related to disease.
• The Distress Thermometer (DT) was used in the control group as a validated questionnaire-based screening tool.
• Both groups underwent baseline, post-consultation, and 3-month follow-up assessments including quality of life and emotional functioning scales.
• The primary outcome was the proportion of distressed patients receiving psychosocial care, as reported by patients and physicians.
• Integration of screening questions into consultations aimed to simplify the process and enhance doctor-patient communication.
• Provision of psychosocial care was prioritized based on urgency, with timely access to psycho-oncological and social-legal support services.

Clinical Implications

Incorporating brief, targeted psychosocial screening questions directly into doctor-patient consultations may improve identification of distress and facilitate timely psychosocial support for patients with high-grade glioma. This approach can complement or potentially enhance standard questionnaire-based screening, addressing neurocognitive and emotional challenges more effectively. Clinicians should consider adapting assessment methods to better meet the complex needs of neuro-oncological patients.

Conclusion

The GLIOPT trial supports the feasibility and potential benefits of physician-led psychosocial assessments integrated into consultations for adults with high-grade glioma. Such strategies may improve detection and management of distress, ultimately enhancing patient care.

References

1. GLIOPT Trial Protocol and Rationale, 2023 -- Comparison of Physician-led and Questionnaire-based Psychosocial Assessments in Adults with High-Grade Glioma
2. NCCN Distress Thermometer Validation Studies, 2010-2015 -- Psychosocial Screening in Brain Tumor Patients
3. EORTC QLQ-C30 and BN20 Modules, 2000-2010 -- Quality of Life Assessment in Neuro-Oncology