Physician-led versus questionnaire-based psychosocial screening in adults with high-grade glioma: a cluster-randomized controlled trial (GLIOPT)

Purpose: Patients diagnosed with high-grade gliomas (HGG) often experience substantial psychosocial dis-tress. However, due to neurological and neurocognitive deficits its assessment remains challenging, and needs remain unmet. We compared a novel face-to-face assessment during doctor-patient conversations with questionnaire-based screening. Methods: In this multicenter, two-arm cluster-randomized study involving 13 centers patients in the interven-tion group (IG) were screened for distress via physician-patient conversations, while the control group (CG) completed the Distress Thermometer. Primary outcome was the proportion of patients with poor emotional functioning (measured with the EORTC Quality of Life Questionnaire) who received specialized psychosocial care (PC) within 3 months. Data were collected via patient and physician reports and medical records. Analysis employed mixed models logistic regression. Results: In total, 763 patients were enrolled at baseline, and 506 completed the follow-up. The emotional functioning was poor in 302/506 (59.7%). The frequency of patients reporting PC utilization was comparable between groups (IG 93/168, 55.4% vs. CG 87/134, 64.9%, odds ratio (OR) =0.67, 95% confidence interval (CI)=0.40-1.11, p=0.115). Likewise, the provision of information about special-ized psycho-oncological care was similar (IG 112/168, 66.7% vs. CG 94/134, 70.1%, OR=0.95, 95%CI=0.39-2.29, p=0.904). Conclusion: Physician-led, face-to-face distress screening was not superior to questionnaire-based screening in facilitating psychosocial care referrals. Nonetheless, it represents a feasible and patient-centered alternative, particularly for patients with high-grade gliomas suffering from neurocognitive or func-tional deficits.