A pilot shared-care model for cancer-related depression
How can a shared care psycho-oncology model improve cancer care?
Clinical depression and anxiety are poorly recognised and treated in the cancer setting, and international studies have determined that around 73% of cases go undetected, resulting in significant distress and reduced quality of life for patients. A shortage of hospital-based psychiatrists and psycho-oncologists in MPCCC partner health services presented an opportunity to use shared-care as an approach to increase accessibility of these services, outside the hospital context and close to where patients live. Shared care is a team-driven approach, in which multidisciplinary healthcare professionals provide care in a coordinated fashion to maximise the care of an individual patient. It is a patient-centred model which focuses on healthcare quality, accessibility and value, and this approach can improve access to supportive care services for cancer patients suffering with clinical depression.
How did MPCCC improve access to psycho-oncology supportive care for patients?
MPCCC’s shared-care pilot involved hospital-based oncologists and psycho-oncologists, specialty-trained community-based psychologists and General Practitioners, and cancer patients from Cabrini Brighton, Monash Cancer Centre Moorabbin and Frankston Hospital who had been recognised as having clinical depression by their treating oncologist.
Expert hospital-based psychiatrists and psycho-oncologists trained and supervised cohorts of community psychologists to deliver evidence based cognitive-coping models of therapy specific to cancer patients for clinical depression. General Practitioners received training and supervision in the application of medication algorithms to support prescription of anti-depressant medication for those in need. Patient progress was carefully measured and the project team coordinated communication across participating healthcare providers.
Is an ongoing shared care psycho-oncology model feasible?
The MPCCC pilot model was found to be highly effective and viable. 24 patients received 6-8 sessions with a community psychologist over a 12-week period, and on conclusion of these sessions, patients were screened using the same “distress thermometer” which had detected symptoms of depression before their participation in the pilot. 78.6% of patients had an improved score. This and other evaluation methods were used to identify not only improvements in mental health, but patients also reported improvements to their quality of life in other ways, including finding daily living tasks easier and feeling more informed about their treatment.
Implementing this pilot shared-care model on a larger scale would enable cancer patients suffering with clinical depression to benefit from access to a coordinated supportive care team that enables timely, affordable, high-quality, cancer-specialised psychology services, close to where they live. Hospitals would benefit from improved workforce capacity, new patient referral pathways and reduced waiting times. Community-based health providers would benefit from specialist training and expanded professional networks.
For more information about this project, read the full evaluation report here.