Implementation of the Distress Assessment and Response Tool at the Kuwait Cancer Control Centre

Background: This report describes the implementation of a comprehensive distress screening program at the Kuwait Cancer Control Center (KCCC), the first such initiative in the Middle East. A Kuwait-Adapted version of the Distress Assessment and Response Tool (K-DART) was used in this screening program. Methods: Paper-based K-DART surveys were piloted in the lymphoma clinic at KCCC in July 2013, followed by gradual hospital-wide expansion. K-DART included patient-reported outcome measures to assess cancer-related physical and emotional symptoms and practical problems. English and Arabic translations of these measures were used. Trained nurses administered K-DART and followed up with the oncologist for patients with moderate-To-high levels of distress. Descriptive data are reported for prevalence of distress, psychosocial oncology program (PSOP) referral rates, and patient and staff satisfaction with K-DART. Results: A total of 1,153 K-DART surveys were completed by 618 patients in the pilot lymphoma clinic, with screening rates increasing from 33.5% to 75.3% over the first 12 months of implementation. Among all K-DART completers, 85/618 (13.8%) were referred to PSOP, whereas only 1/955 (0.1%) of K-DART noncompleters were referred to PSOP. After hospital-wide expansion of screening, a total of 2,017 patients completed K-DART in the first year of implementation. Both patients and physicians reported high satisfaction with K-DART, which was reported to enhance patient-physician communication and improve clinical care. Conclusion: Implementation of K-DART in a Middle Eastern country is feasible and facilitates a more comprehensive approach to cancer care, contributing to the successful establishment of a PSOP at the KCCC.