In part 2 of the interview, Nina Balanchivadze, MD, Sarah Cannon Research Institute at Virginia Oncology Associates, and Kyle Lavin, MD, MPH, UNC School of Medicine, University of North Carolina at Chapel Hill, discuss the findings of a study evaluating the integration of virtual collaborative behavioral health care for patients with breast cancer.
The findings presented stems from a retrospective analysis of 207 patients diagnosed with breast cancer who were enrolled in a specialized virtual collaborative care program. The primary objective of the study was to determine if this integrated model could produce clinically meaningful and statistically significant improvements in both mental health outcomes and overall quality of life over a specific duration of time. The researchers highlighted that the findings were particularly important given the complex needs of the specific patient population they treat.
Clinical Improvements in Mental Health
The study utilized standardized tools to measure psychological distress among participants. By the fifth month of the program, researchers observed a significant reduction in depression symptoms, with scores on the PHQ-9 scale decreasing by more than 6 points. Similarly, anxiety symptoms were assessed using the GAD-7 tool, which showed a decrease of almost 5 points within the same 5-month timeframe. Beyond these specific metrics, the analysis revealed that the quality of life for these patients improved longitudinally.
Operational Success and Treatment Adherence
The benefits of the virtual collaborative care model extended beyond psychological metrics into the operational aspects of oncology. Data gathered from surveyed patients indicated that seventy percent experienced an improved ability to keep their oncology appointments. Furthermore, 65% of participants reported better adherence to their nonchemotherapy medications. These results suggest that addressing mental health directly impacts a patient’s ability to engage with their physical cancer treatment.
Researcher Reflections and the Magnitude of Change
The researchers expressed surprise at the magnitude of the improvement demonstrated in the study. There was an initial concern that because the cancer experience involves many nonmodifiable stressors, the degree of measurable improvement might be limited. However, the data revealed a much larger difference in patient outcomes than anticipated, especially considering the relatively short 5-month window.
Equity Signals and Future Directions
A significant portion of the discussion focused on health equity and disparities. The study included a higher percentage of minority and Medicaid patients, and the researchers are now looking internally at how to better engage these specific populations. Notably, the analysis found that larger gains in quality of life scores were observed among Black patients compared with White patients. While these findings are considered exploratory, they serve as an “equity signal,” suggesting that virtual integrated models may help reduce the access barriers that disproportionately affect historically underserved patients. The team intends to study these disparities more rigorously and present further findings in the future.