A pilot shared-care model for cancer-related depression

A pilot shared-care model for cancer-related depression 2019-12-10T16:08:09+00:00

MPCCC’s pilot of a shared-care model for cancer-related depression piloted a coordinated system of supportive care for patients suffering from clinical depression during cancer treatment. 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. 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.

Methodology

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. 

Independent evaluation

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. The pilot is highly viable for implementation across MPCCC and will inform planning for future shared-care model pilots.

Pilot impact

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.

The pilot began in August 2018 and concluded in October 2019, and its evaluation demonstrated that the piloted shared-care model for cancer related depression is highly effective and viable. See here for a copy of the final report. For more information, contact the Project Chief Investigator David Kissane on david.kissane@monash.edu.

 

 

MPCCC acknowledges the support of the Victorian State Government.