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Objective Pain and depression are two of the most prevalent and treatable cancer-related symptoms, each present in at least 20-30% of oncology patients. Both symptoms, however, are frequently either unrecognized and/or undertreated. The objective is to describe a telecare management intervention delivered by a nurse-psychiatrist team that is designed to improve recognition and treatment of pain and depression. The enrolled sample is also described. Method The Indiana Cancer Pain and Depression (INCPAD) study is an NCI-sponsored randomized clinical trial. A total of 405 patients with cancer-related pain and/or clinically significant depression from 16 urban or rural oncology practices throughout Indiana have been enrolled and randomized to either the intervention or a usual care control group. Intervention patients receive centralized telecare management coupled with automated home-based symptom monitoring. Outcomes will be assessed at 1, 3, 6 and 12 months by research assistants blinded to treatment arm. Results Of 4465 patients screened, 2185 (49%) endorsed symptoms of pain or depression. Of screen-positive patients, about one-third were ineligible (most commonly due to pain or depression not meeting severity thresholds, or pain that is not cancer-related). Of the 405 patients enrolled, 32% have depression only, 24% pain only, and 44% both depression and pain. At baseline, participants report an average of 16.8 days out of the past 4 weeks in which they were confined to bed or had to reduce their usual activities by ≥ 50% due to pain or depression. Also, 176 (44%) report being unable to work due to health reasons. Conclusions When completed, the INCPAD trial will test whether centralized telecare management coupled with automated home-based symptom monitoring improves outcomes in cancer patients with depression and/or pain. Findings will be important for both oncologists and mental health clinicians confronted with oncology patients' depression or pain.

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