Effectiveness of psychosocial support for people with canvcer offered at de Vruchtenburg

Objectives To review the reimbursement of psychosocial support for people with cancer according to the effectiveness principles of the Dutch Board of Health Insurance. Methods This study consists of three parts: (1) A literature research in The Cochrane Library, PubMed and sEURch for (systematic) reviews and meta-analyses on existing evidence regarding the effectiveness of the therapies that are offered at de Vruchtenburg; (2) a comparison between the therapies in the evidence found and the therapies offered at de Vruchtenburg; (3) a description of research done by de Vruchtenburg itself to measure the effectiveness of the therapies offered at de Vruchtenburg. Result The literature review found 11 studies of EBM level A1 and 2 studies of EBM level B. Almost all reviews show positive improvements in different outcome measures: anxiety, depression, quality of life, fatigue, social wellbeing, and etcetera. The authors of the reviews indicated that there are only a few RCTs available. Therefore they recommend additional RCT research in the field of psychosocial support, to make the outcomes of the reviews stronger. However, only the mindfulness-based stress reduction course as offered at de Vruchtenburg was truly comparable to the mindfulness-based stress reduction courses in the literature study. Three studies performed by de Vruchtenburg indicated positive effects, but are classified as lower level evidence. Conclusion The therapies offered at de Vruchtenburg mostly do not comply with the effectiveness requirements for reimbursement of the CVZ. However, as there is evidence for the effectiveness of psychosocial support, de Vruchtenburg may adapt their current protocols for psychosocial support to those who have been shown to be effective. Alternatively, de Vruchtenburg can perform effectiveness studies on their own, which meet the criteria of RCTs.