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).


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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.

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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.

Reference

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