Mixed Benefit of Nurse Navigation in Psychologically Vulnerable Breast Cancer Patients

An intervention involving nurse navigation did not significantly reduce symptoms of distress in breast cancer patients with psychological vulnerability, according to research published in JAMA Network Open.

However, the intervention did result in lower rates of depression and better breast cancer-specific health-related quality of life in these patients, reported the investigators of the REBECCA trial.

The trial (ClinicalTrials.gov Identifier: NCT03254875) included 309 adult women with newly diagnosed breast cancer who had psychological distress at a score of at least 7 on the Distress Thermometer. The patients were randomly assigned to receive either the REBECCA intervention plus standard care (n=156) or standard care alone (n=153).

The REBECCA intervention included symptom screening and nurse navigation, which involved individual sessions to check in on patient need. Standard care included regular treatment, nurse-based support at appointments for chemotherapy and radiotherapy, and rehabilitation through municipality-based services.

Symptoms of distress, the primary outcome of the trial, were numerically reduced in the group receiving the intervention compared to standard care only, but differences between the groups at 6, 12, and 18 months were not statistically significant. At the 12-month follow-up, the estimated effect for this metric was -0.51 (95% CI, -1.05 to 0.04; P =.07).

Symptoms of depression, a secondary outcome, were significantly reduced at 6 months for the intervention group compared to the standard care group (estimated effect, -1.39; 95% CI, -2.33 to -0.44; P =.004).

Additionally, breast cancer-specific health-related quality of life, another secondary outcome, was significantly better at 12 months for the intervention group than the standard care group (estimated effect, 4.03; 95% CI, 1.28-6.77; P =.004).

“These findings warrant further research to develop the nurse navigation framework and to explore the potential translation of this intervention into clinical practice,” the researchers concluded.

Disclosures: This research was supported by TrygFonden. One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Bidstrup PE, Johansen C, Kroman N, et al. Effect of a nurse navigation intervention on mental symptoms in patients with psychological vulnerability and breast cancer: The REBECCA randomized clinical trial. JAMA Netw Open. Published online June 23, 2023. doi:10.1001/jamanetworkopen.2023.19591