Cancer survivors experienced symptom improvement with a telephone-assisted self-care intervention for depression. These findings from a randomized superiority trial were published in the Journal of Clinical Oncology.

The study compared the Cancer Depression Intervention via Referral, Education and Collaborative Treatment (CanDirect), a telephone-based intervention for depression, plus usual care with usual care (UC) alone. In the study, 245 cancer survivors who had completed treatment within the past 10 years and had moderate depression were randomly assigned in a 1:1 ratio to receive usual care alone (124 participants) or with CanDirect (121 participants). The intervention group received a Depression Self-Care Toolkit for Cancer Survivors and were offered up to 15 telephone coaching sessions lasting a mean of 14.5 minutes. Patients were assessed for symptoms of depression at 6 months.

Participants in the intervention and control groups, respectively, were mean age 58.3 and 56.9 years, 75.2% and 82.3% were women, 52.5% and 44.4% were 6 months to 3 years posttreatment, and 17.4% and 25.0% had major depression.

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Participants in the CanDirect cohort received an average of 7.8 (range, 1 to 14) coaching calls.

At 6 months, the patients who received the intervention were more likely to have reduced symptoms of depression (adjusted odds ratio [aOR], 5.97; 95% CI, 2.69-13.25; P <.001) or depression in remission (aOR, 2.54; 95% CI, 1.41-4.57; P <.001) and less likely to have major depression (aOR, 0.31; 95% CI, 0.10-0.93; P =.04).

Stratified by gender, women benefitted from the CanDirect intervention (effect size [ES], 0.86; 95% CI, 0.54-1.17; P <.001) compared with men (ES, 0.12; 95% CI, -0.45 to 0.69; P =.68).

This study was limited by the fact that fewer patients in the intervention (82.6%) than the control (95.2%; P =.002) group completed the study.

These observations indicated depression self-care with coaching by lay professionals may be a cost-effective therapy for some cancer survivors with depression.


McCusker J, Jones J M, Li M, et al. CanDirect: effectiveness of a telephone-supported depression self-care intervention for cancer survivors. J Clin Oncol. Published online February 8, 2021. doi:10.1200/JCO.20.01802