Effectiveness Study of a Stepped Care Depression Algorithm for Patients With Cancer
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Major Depression
- Sponsor
- University of Southern California
- Enrollment
- 472
- Locations
- 1
- Primary Endpoint
- Reduced Depression Symptoms
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
The ADAPt-C collaborative depression care model is designed to: improve depression symptom reduction in the intervention group over the modestly enhanced usual care group of low-income, predominantly Hispanic, patients with cancer who are receiving care in an urban public sector care system; and to improve quality of life outcomes among intervention patients over enhanced usual care.
Detailed Description
This controlled trial has tested the effectiveness of a socio-culturally tailored depression care program that includes a patient-centered approach to antidepressant medication management or structured psychotherapy (Problem Solving Treatment (PST)), patient/family depression education, treatment maintenance and relapse prevention counseling. Intervention enhancements include: depression care management based on a stepped care depression treatment algorithm; extension of the oncology care management team with a master's degreed social worker, who acts as Cancer Depression Clinical Specialist (CDCS) and provides PST, treatment follow-up and feedback to the oncologist, and who facilitates patient-provider communication and health system and community resources navigation; a psychiatric consultant, who provides supervision of the CDCS and consultation and antidepressant medication prescription for individual patients; and a didactic for oncologists on depression management. Cultural sensitivity and competency enhancements include: patient choice of first line treatment (antidepressant medication/PST) and degree of family participation in their depression care; PST tailored for language and literacy of patients with cancer; bilingual, bicultural CDCS; Spanish educational materials; and communication facilitation. Enhanced Usual Care (EUC) patients will receive the care and services routinely provided patients with cancer plus an educational/resource pamphlet for patients and for family members(on depression and cancer, depression treatment, talking with your doctor about your depression, and medical center and community mental health care resources). With patient consent, the oncologist is informed if EUC patients screen positive for major depression/dysthymia.
Investigators
Kathleen R. Ell
Professor
University of Southern California
Eligibility Criteria
Inclusion Criteria
- •90 days post cancer diagnosis receiving acute cancer treatment or active follow-up
Exclusion Criteria
- •patients with advanced cancer or another medical condition that limited life expectancy to less than 6 months
Outcomes
Primary Outcomes
Reduced Depression Symptoms
Time Frame: 12 months
Number of participants with 50% PHQ-9 score reduction since baseline
Secondary Outcomes
- Physical Composite Summary Score (PCS) Derived From the 12-item Short Form (SF-12) Health Survey(12 months)