Monday, September 8, 2014

Collaborative Care Improves Depression in Cancer Patients, Studies Find

A trio of related studies from the United Kingdom appearing in Lancet, Lancet Oncology, and Lancet Psychiatry reveals that nearly three-quarters of cancer patients who have major depression are not currently receiving any depression treatment. However, the studies also demonstrate that a program of integrated collaborative care is highly effective at reducing this co-occurring depression, even in cancer patients with a poor prognosis.

Known as Depression Care for People with Cancer (DCPC), this program provides both antidepressants and psychotherapy in a systematic fashion, with cancer nurses and psychiatrists working together with primary care physicians. The DCPC was compared with usual care in a pair of multicenter clinical trials called SmaRT Oncology-2 and SMaRT Oncology-3.

The Oncology-2 trial involved 500 adults with major depression and cancer who had a good prognosis. After 24 weeks, 62% of patients receiving the DCPC intervention responded to treatment, compared with only 17% receiving usual care. The DCPC recipients also reported less anxiety and fatigue, and a better quality of life.

The Oncology-3 trial adapted the integrated care program for testing in 142 lung-cancer patients, who typically have a poor prognosis, and correspondingly, a higher prevalence of depression. However, DCPC was still effective in this group, as patients reported greater improvements in their depression, anxiety, and quality of life compared with subjects in usual care.

And a key side benefit was that DCPC was cost-effective; for the Oncology-2 trial, for example, the integrated care only added around $1,000 per patient, which included all treatment sessions, treatment supervision, and telephone discussions about depression care.

To read more about how integrated care can help reduce health care costs, see the Psychiatric News article, “Shifting to Integrated Care Will Save Health System Huge Sums, Report Finds.”

NOTE: This week is National Suicide Prevention Week, and World Suicide Prevention Day is September 10. On that day from noon to 1 p.m., EDT, APA will be holding a Twitter chat on suicide and suicide prevention, hosted by Gabriela Cora, M.D. The Twitter chat is one of a series that provides an opportunity for psychiatrists to lead conversations on current mental health issues and be involved with key influencers, allied groups, patients, and the public at large.



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