JPOS/JASCC clinical guidelines for psychological distress in adult cancer patients: a summary of recommendations.

OBJECTIVES

This article aims to describe the newly developed Japanese practice guidelines for psychological distress of adult individuals with cancer who have elevated levels of psychological distress.

METHODS

We conducted systematic reviews and Delphi consensus rounds to determine the levels of certainty of evidence and strength of recommendation.

RESULTS

In our proposed flow of care, all individuals with cancer should initially be provided with general support, comprising supportive communication, detection of psychological distress, attendance to their needs, and differentiating physical conditions that mimic psychological distress. If a patient still has significant psychological distress despite such support, more specific care for psychological distress should be considered. Collaborative care has strong evidence base and is strongly recommended. Evidence for psychotherapy for psychological distress and fear of cancer recurrence is moderate to strong, however, recommendations for these interventions were weakened because of the heterogeneity of interventions and lack of formal training system. Evidence of pharmacotherapy was weak. Thus, anxiolytics are weakly recommended only for short term and should be accompanied with psychosocial support. Antidepressants are weakly recommended when a patient is diagnosed with depression. Early specialized palliative care, care for caregivers and peer support are not recommended as a sole means to alleviate psychological distress, due to the scarce supporting evidence. Provision of these interventions is not hindered when they aim to improve the outcomes other than psychological distress, such as quality of life, symptom burden and self-efficacy.

DISCUSSION: New practice guidelines for psychological distress of adult individuals with cancer have been developed.