Consultation by medical physicists with patients can help reduce anxiety and increase satisfaction with radiation treatment

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

“This study is a wake-up call for medical physicists that there are new ways we can add value to patient care,” said Todd F. Atwood, Ph.D., lead author of the study and associate professor and senior associate division director of Transformational Clinical Physics from the University of California, San Diego. “It shows how care teams can collaborate more effectively with patients as they make their treatment decisions and manage the radiation therapy process.”

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

The new findings suggest that medical physicists can also complement patient education and potentially improve patient outcomes by reducing patients’ treatment-related stress. “Increasingly, patients want to be more involved in their care,” said Dr. Atwood. “They’re looking for more information. They usually search online first, but what they find is either unspecific or just too complex. They have unanswered questions that often lead to confusion, stress, and anxiety.”

Previous studies have shown that patient-related stress can adversely affect outcomes after radiation therapy. dr Atwood and his colleagues hope this approach can also help improve patient outcomes by reducing stress and anxiety related to their treatment.

In this study, researchers randomized 66 patients seeking external beam radiation therapy into two treatment arms: one who would receive Physics Direct Patient Care (PDPC) before and during radiation treatment, and one who would not receive PDPC radiation therapy. The patients had different types of primary cancer, most commonly breast, gynecologic or prostate cancer, and most were receiving radiation therapy for the first time.

In addition to traditional care, where patients only discuss their treatment with their radiation oncologist, the PDPC group received two pre-treatment consultations with a medical physicist who explained the technical aspects of their care – how the treatment is planned and delivered, how the radiation therapy technology is used works and “anything that helps keep them safe during treatment,” said Dr. Atwood. The medical physicist remained a point of contact for patients if additional questions arose at any point during the treatment process.

Prior to interacting with patients, the five medical physicists participating in the study completed a patient communication training program that included radiation oncology-specific lectures, role-play exercises, simulated patient interactions and analysis, and supervised doctor-patient consultations that included analysis of these interactions.

Changes in treatment-related anxiety, overall satisfaction with treatment, and satisfaction with their understanding of technical aspects of care were measured over the course of treatment using patient questionnaires.

Patients receiving medical physicist consultations had significant improvements in anxiety and both satisfaction metrics compared to patients receiving treatment without the additional consultations. Anxiety did not differ between groups at baseline or after the simulation appointment, but was lower on average in patients who consulted the physician after the first treatment (30.2 vs. 37.6, on a 60-item assessment, p = 0.027). However, at the end of treatment, the difference in mean anxiety scores was no longer significant.

To examine more closely the differences in anxiety between the groups, the researchers specifically looked at the number of patients who reported high levels of anxiety during treatment. While there were no significant differences in the proportion of patients with high anxiety at baseline, after the simulation appointment, or after the first treatment, a significant difference occurred at the end of treatment (12.5% ​​vs. 38.9% reported high anxiety, p=0.047 ).

While the consultations were generally beneficial for patients, Dr. Atwood said they could be particularly useful for patients who are more prone to anxiety. Among those who received the additional consultations, the percentage of patients reporting high levels of anxiety fell by more than half over the course of treatment, from 31.3% to 12.5%.

The biggest difference between the groups was how satisfied patients were with their understanding of the technical aspects of their care. While there was no difference between the groups at baseline, the group that received additional counseling at the simulation appointment immediately demonstrated greater satisfaction with their technical understanding of nursing (6.2 vs. 5.1 on a 7-point scale, p=0.005). Technical satisfaction scores increased for both groups throughout treatment but remained significantly higher for patients receiving additional consultations, reaching 6.6 out of seven for this group compared to 5.5 for the standard of care group (p=0.002 ).

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

dr Atwood said he was curious to see how long the benefits of the supplemental consultation would last. “It has a lasting effect,” he says. “We’ve believed for years that medical physics consultants have great potential, but now we have a clearer understanding of how they positively impact the patient experience.”

While other members of the care team could also be consulted to provide patients with a deeper understanding of their care, Dr. Atwood that he believes medical physicists are uniquely suited for the role because they are so familiar with the science that drives the technology being used.

“People don’t realize how personalized this therapy actually is. Medical physicists are working behind the scenes to ensure this personalized treatment is both safe and effective. Our study shows that there can also be a patient-centric role that allows medical physicists to add value to the patient experience,” he said.