Management for depression symptoms (DS) may be an unmet need for many patients with cancer diagnoses, according to results of a study published in The Oncologist.
“We identified a worrisomely low proportion of patients reporting DS who received psychosocial interventions,” the study investigators wrote in their report.
The study was a population-based cohort analysis of psychosocial interventions following screening for depression symptoms in patients from Ontario, Canada, who obtained cancer diagnoses in the years of 2010 through 2017. Eligible patients (N=142,270) were those for whom at least 1 patient-reported Edmonton Symptom Assessment System (ESAS) score was available. An ESAS score of 2 or higher for depression was used to define the presence of DS.
Nearly half (46.0%) of patients reported DS, which appeared at a median of 66 days following cancer diagnosis (interquartile range [IQR], 34-105).
The median study follow-up time was 32 months (IQR, 16-56) after diagnosis, and 47.3% of the patients in this study died by follow-up.
Some patients reporting DS received psychosocial interventions, such as a palliative care assessment (17.1%), a social work referral (8.4%), and a psychiatric or psychological assessment (1.7%). Antidepressant prescriptions were filled by 5.8% of patients with DS who were aged 65 or older. Patterns of psychosocial interventions received were varied across multiple patient demographic groups.
Improvements in DS were seen in more than 70% of patients given antidepressant treatment, approximately two-thirds of patients given a social work referral or a palliative assessment, and a slightly lower percentage (63.7%) of those given a psychiatric or psychological assessment.
“These data are important as they represent a call to action to modify current practice to facilitate interventions and optimize the usefulness of systematic symptom screening” concluded the study investigators in their report.
Hallet J, Davis LE, Isenberg-Grzeda E, et al. Gaps in the management of depression symptoms following cancer diagnosis: a population-based analysis of prospective patient-reported outcomes [published online February 26, 2020]. Oncologist. doi: 10.1634/theoncologist.2019-0709