Improving Primary Care for Older Adults with Cancer and Depression

Fann, Jesse R.; Fan, Ming‐Yu; Unützer, Jürgen

doi:10.1007/s11606-009-0999-4

Cited by 77 publications

(103 citation statements)

References 50 publications

(46 reference statements)

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“…Three other smaller trials [34,43,47] reported somewhat larger effects for fluoxetine (Hedges's g = 0.36) [43] and mianserin (Hedges's g = 0.60 to 0.77) [34,47]. Among collaborative care trials, effect sizes were small to moderate for adequately powered trials (Hedges's g = 0.17 to 0.47) [35,37,40,44] and moderate to large for a smaller study (Hedges's g = 0.60) [46]. The effect sizes for outcomes reported in a trial of problem-solving therapy trial [42], comparing problem-solving therapy to a wait-list control (Hedges's g = 3.76) or problem-solving therapy with a significant other to the wait-list control (Hedges's g = 4.30) were exceedingly large.…”

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

“…As shown in Table 1, the 14 studies of interventions to reduce psychological distress we reviewed included 12 studies of patients with mixed cancer sites [34][35][36][37][38][39][40][41][42][43][44][45], 1 study with patients with breast or cervical cancer [46], and 1 study with patients with breast cancer only [47]. Total sample size per study ranged from 55 to 472.…”

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

“…Total sample size per study ranged from 55 to 472. Of the 14 studies, 7 randomized at least 64 patients per group [35,[37][38][39][40]44,45], which would provide adequate (80%) power to detect a medium effect size (standardized mean difference = 0.50) [48].…”

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

“…The other 10 studies included collaborative care interventions [35,37,40,44,46], cognitive behavior therapy [36,39,41], problem solving therapy [42], and aromatherapy massage [45]. Among the drug trials, there was 1 study [38] with at least 64 patients per group, and that study found a small effect size reduction on self-reported depressive symptoms with fluoxetine (Hedges's g = 0.23).…”

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

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Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

Meijer

Roseman

Delisle

et al. 2013

Journal of Psychosomatic Research

117

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Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

Section: Review Question #1: Effect Of Treatment Of Psychological Dismentioning

confidence: 99%

See 2 more Smart Citations

Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

Meijer

Roseman

Delisle

et al. 2013

Journal of Psychosomatic Research

117

View full text Add to dashboard Cite

“…Furthermore, interventions aiming at improving depression management, education and behavioral activation (i.e. emphasizing pleasant event scheduling and overcoming avoidance behaviors), along with the use of antidepressant treatments when appropriate, have been recognized as effective in reducing depressive burden in individuals with cancer 9 .…”

Section: Introductionmentioning

confidence: 99%

Depression in cancer: The many biobehavioral pathways driving tumor progression

Bortolato

Hyphantis

Valpione

et al. 2017

Cancer Treatment Reviews

251

179

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Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote:(1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitary-adrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioural pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed.

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Effect of Telecare Management on Pain and Depression in Patients With Cancer

Kroenke

Theobald

et al. 2010

JAMA

297

306

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Context Pain and depression are two of the most prevalent and treatable cancer-related symptoms, yet frequently go unrecognized and/or undertreated. Objective To determine whether centralized telephone-based care management coupled with automated symptom monitoring can improve depression and pain in cancer patients. Design, Setting, and Patients Randomized controlled trial conducted in 16 community-based urban and rural oncology practices across the state of Indiana. Recruitment occurred from March 2006 through August 2008 and follow-up concluded in August 2009. The 405 patients had depression (Patient Health Questionnaire-9 score ≥ 10), cancer-related pain (Brief Pain Inventory worst pain score ≥ 6), or both. Intervention Patients were randomly assigned to the intervention (n=202) or to usual care (n=203), stratified by symptom type. Intervention patients received centralized telecare management by a nurse-physician specialist team coupled with automated home-based symptom monitoring by interactive voice recording or internet. Main Outcome Measures Blinded assessment at baseline, 1, 3, 6, and 12 months for depression (20-item Hopkins Symptom Checklist [HSCL-20]) and pain (Brief Pain Inventory [BPI]) severity. Results There were 131 patients enrolled with depression only, 96 with pain only, and 178 with both depression and pain. Of the 274 patients enrolled for pain, the 137 intervention patients had greater improvements than the 137 usual care patients in BPI pain severity over the 12 months of the trial whether measured as a continuous severity score or as a categorical pain responder (P < .0001 for both). Similarly, of the 309 patients enrolled for depression, the 154 intervention patients had greater improvements than the 155 usual care patients in HSCL-20 depression severity over the 12 months of the trial whether measured as a continuous severity score (P < .0001) or as a categorical depression responder (P < .001). The standardized effect size for between-group differences at 3 and 12 months was .67 and .39 for pain, and .42 and .44 for depression. Conclusion Centralized telecare management coupled with automated symptom monitoring resulted in improved pain and depression outcomes in cancer patients receiving care in geographically-dispersed urban and rural oncology practices.

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Improving Primary Care for Older Adults with Cancer and Depression

Cited by 77 publications

References 50 publications

Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

Depression in cancer: The many biobehavioral pathways driving tumor progression

Effect of Telecare Management on Pain and Depression in Patients With Cancer

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