New Treatment Strategy Improves Depression in Patients With Cancer

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Title: New Treatment Strategy Improves Depression in Patients With Cancer
URL: http://www.pslgroup.com/dg/224EBA.htm
Doctor's Guide
July 3, 2008

NEW YORK -- July 3, 2008 -- A new care package -- Depression Care for People With Cancer (DCPC) -- can reduce levels of depression in cancer patients and is a cost-effective method in improving quality of life when compared with current cancer treatments, according to a study in the July 5 edition of The Lancet.

Michael Sharpe, University of Edinburgh, Edinburgh, United Kingdom, and colleagues, assessed the efficacy and cost of a new nurse-delivered complex care package designed for cancer patients with depression in the Symptoms Management Research Trials (SMART) oncology 1 trial.

The randomised trial, included 200 patients at a regional cancer centre in Scotland. All patients had a cancer prognosis of greater than 6 months and major depression. Their mean age was 56.6 years, and 141 (71%) were women.

Of the patients, 99 were randomised to receive the usual care for depression from their general practitioner and cancer team, and 101 were randomised to receive the usual care supplemented with DCPC. Patients given DCPC were offered an average of 7 one-on-one sessions over 3 months with a specially-trained cancer nurse.

The sessions aimed to help patients understand depression and its treatments, and provided problem-solving treatment to help patients overcome feelings of helplessness. The nurse also communicated with each patient's oncologist and primary care physician about the management of their depression. After completing initial treatment the nurse monitored the patients' progress by telephone and provided optional booster sessions if needed.

The patients' depression level was measured using the self-reported Symptom Checklist-20 depression scale (range, 0-4) and also by interview at 3, 6, and 12 months in both groups.

Researchers found that for patients receiving DCPC, depression levels were lower, with a difference of 0.34 on the depression scale. The proportion of patients with major depression was 23% lower in the DCPC group, and the benefits of the intervention on depression were still evident at 12 months. The DCPC intervention also improved anxiety and fatigue, but did not improve pain or physical functioning.

"The intervention -- Depression Care for People With Cancer -- offers a model for the management of major depressive disorder in patients with cancer and other medical disorders who are attending special medical services that is feasible, acceptable, and potentially cost effective," the authors wrote.

"Ten percent of cancer patients experience clinical depression and, unfortunately, it is not always adequately treated. This new treatment could substantially improve the way we manage depression in people with cancer and also in people with other serious medical conditions."

SOURCE: The Lancet

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