Progress in the Implementation of NCCN Guidelines for Distress Management by Member Institutions

A 2005 survey of NCCN Member Institutions was among the first studies to evaluate the extent to which key elements of the NCCN Clinical Practice Guidelines in Oncology for Distress Management were being implemented as part of routine clinical practice. This study seeks to characterize current implementation of the guidelines by NCCN Member Institutions 7 years after the original study. Institutional representatives appointed to the NCCN Distress Management Panel were asked to complete an online survey in June 2012. The survey was similar to the 2005 survey, except that it solicited additional details about screening procedures. The survey was completed by representatives from 20 of 22 NCCN Member Institutions (91%). (Note: In this calculation, 1 consortium cancer cancer was counted as 2 NCCN Member Institutions.) Responses indicate that routine screening for distress is being conducted at 70% of institutions, with 25% screening inpatients and 60% screening outpatients. Among institutions screening outpatients, 50% screen all outpatients and 50% screen only certain subgroups of outpatients. In terms of method, 85% of institutions conducting screening use a patient self-report measure either alone or in combination with an interview; the Distress Thermometer is used at 59% of institutions that use a self-report measure. Findings show modest progress since 2005 in implementing guideline recommendations regarding distress screening, with a 7% increase in institutions conducting any routine screening and a 10% increase in institutions screening all outpatients routinely. Greater progress is evident in the use of self-report measures as part of screening, with a 23% increase in their use alone or in combination with an interview.