Pathfinders is a multi-faceted psychosocial care program for cancer patients; it was developed in community oncology and adapted to the academic oncology setting. A prospective, single-arm, phase 2 pilot study by Abernethy and colleagues examined the acceptability and feasibility of Pathfinders for women with metastatic breast cancer. Over three months, participants completed patient-reported surveys including the Patient Care Monitor (PCM), Functional Assessment of Chronic Illness Therapy-Breast Cancer (FACT-B), Self Efficacy, and a single-item survey asking patients whether the program was helpful to them. A technology-based data collection system was used to capture electronic patient-reported outcomes at point of care, report symptoms in real time to clinicians, and collect warehouse data to provide a detailed longitudinal picture of the patient experience when receiving Pathfinders. Participants (n = 50) were: mean age 51; 76% white, 20%, black; 74% married; and 50% college degree. Forty-two patients completed baseline and three-month assessments. Statistically significant improvements (all P < 0.05) occurred in PCM subscales for Distress, Despair, and Quality of Life, and the FACT-B Emotional Wellbeing subscale. Of the 29 participants asked if Pathfinders was helpful, 27 (93%) responded positively and two did not respond. Other instruments measuring symptoms, quality of life, and self-efficacy showed improvement.

WHAT THE STUDY MIGHT MEAN TO YOU AS A HEALTH CARE PROVIDER: In a phase 2 pilot study, Pathfinders was helpful to patients and is feasible in an academic medical center. Follow-up data collected at the three-month assessment suggest that the program impacts various psychological outcomes, notably distress and despair.

WHAT THE STUDY MIGHT MEAN TO YOU AS A PATIENT: Results of the study are encouraging. However, additional research is needed to determine if test the program back in the community. In addition, three months is too short a duration to determine whether patients performed the functions they were taught in the Pathfinder program. It is hoped that further research will answer these issues.

AP Abernethy et al. Phase 2 pilot study of Pathfinders: a psychosocial intervention for cancer patients. Support Care Cancer, February 9, 2010.