MPCCC’s pilot shared-care model for cancer-related depression fits within Collaborative Platform 3: ‘Increasing service capacity to address patient needs through innovative shared-care models’ in the MPCCC 2017-2021 Strategic Plan.
Clinical depression and anxiety are poorly recognised and treated in the cancer setting. 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-centric 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 pilot shared-care model for cancer related depression involves hospital-based oncologists and psycho-oncologists, specialty-trained community-based psychologists and General Practitioners, working together to provide a co-ordinated system of care.
Progress to date
The pilot was conducted across MPCCC Partner hospitals including Cabrini Brighton, Monash Cancer Centre Moorabbin and Frankston Hospital. Cancer patients in whom treating oncologists had identified symptoms of depression using a “distress thermometer” were eligible to participate.
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.
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.
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.
See here for details of the Project Team and Steering Committee.
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MPCCC acknowledges the support of the Victorian State Government.