Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

“Signing up for the PRoCESS [Pancreatic cancer Relatives Counselling and Education Support Service] Trial was the most important thing I did as a carer” (#97)

Vanessa L Beesley 1 2 3 , Natalie Roset 1 , Jane Turner 4 , Patsy Yates 3 , David Wyld 3 4 5 , Melissa Eastgate 4 5 , Raymond Chan 6 , Louisa Collins 7 , Michelle Stewart 8 , Hanna Beebe 1 , Maryrose Malt 1 , Caroline Kelly 9 , Rachel Neale 4 10
  1. Psychedelic Medicine and Supportive Care Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
  2. School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
  3. School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
  4. Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
  5. Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, QLD, Australia
  6. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
  7. Health Economics Lab, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
  8. PanKind, The Australian Pancreatic Cancer Foundation, Sydney, New South Wales, Australia
  9. Consumer Representative, Sydney, New South Wales, Australia
  10. Cancer Aetiology & Prevention Group , QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia

Background:
Pancreatic cancer is rare and lethal, leaving patients and their families little time to adjust to the diagnosis. Family carers are thrust into roles requiring them to manage complex physical symptoms, while also providing emotional, financial, and spiritual support, often with minimal guidance. This study aimed to evaluate the effects of a nurse-led counselling support service on carer and patient-reported outcomes, survival, and use of medical services. Data collection will be completed October 2024. Preliminary results are presented.

Methods:
PRoCESS is a hybrid effectiveness-implementation trial. Carers of patients with pancreatic cancer were randomised 1:1 to: (i) structured telephone counselling intervention plus a comprehensive information package; or (ii) the information package alone. The intervention, grounded in a self-efficacy paradigm, involved assessing stressors and delivering psychoeducation. Participants in the intervention were offered ten one-hour video conferencing or telephone sessions over four months, with optional monthly sessions thereafter. Participating carers and patients completed questionnaires and consented to data linkage.

Results:
A total of 181 Australian carers were randomised to: 1) intervention group (n=53 carers without participating patients; n=35 carer-patient dyads; n=3 carer-carer dyads; and n=1 carer-carer-patient triad); and 2) control group (n=47 carers participating alone; n=36 carer-patient dyads; and n=1 carer-carer-patient triad). The majority of carer participants were female, caring for patients with non-resectable disease, and nearly half resided outside capital cities. All except 6 intervention participants completed or are on track to complete at least six counselling sessions, meeting the fidelity threshold. To date, 734 core and 484 optional counselling sessions have been delivered. The most significant stressors initially expressed by intervention participants centred around: (1) coping with uncertainty; (2) carers’ own health; (3) patient concerns; and (4) family concerns. At the end of the intervention, participants reported valuing the continuous support over time and the opportunity to share their concerns and experiences with an impartial listener who has the expertise to provide practical and emotional support.

Conclusions and Significance:
Preliminary findings suggest that the telehealth nurse-led counselling intervention is a valuable resource for carers, is accessible to all, and has the potential to improve patient outcomes and reduce health-care costs.