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Systematic review and meta‐analysis of collaborative care interventions for depression in patients with cancer
Author(s) -
Li Madeline,
Kennedy Erin B.,
Byrne Nelson,
GérinLajoie Caroline,
Katz Mark R.,
Keshavarz Homa,
Sellick Scott,
Green Esther
Publication year - 2017
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4286
Subject(s) - psychological intervention , psycinfo , meta analysis , medicine , collaborative care , randomized controlled trial , medline , depression (economics) , cochrane library , systematic review , psychiatry , mental health , political science , law , economics , macroeconomics
Background Previous systematic reviews have found limited evidence for the effectiveness of pharmacological and psychological interventions for the management of depression in patients with cancer. This paper provides the first meta‐analysis of newer collaborative care interventions, which may include both types of treatment, as well as integrated delivery and follow‐up. Meta‐analyses of pharmacological and psychological interventions are included as a comparison. Methods A search of MEDLINE, EMBASE, PsycINFO, and the Cochrane Library from July 2005 to January 2015 for randomized controlled trials of depression treatments for cancer patients diagnosed with a major depressive disorder, or who met a threshold on a validated depression rating scale was conducted. Meta‐analyses were conducted using summary data. Results Key findings included eight reports of four collaborative care interventions, eight pharmacological, and nine psychological trials. A meta‐analysis demonstrated that collaborative care interventions were significantly more effective than usual care (standardized mean difference = −0.49, p = 0.003), and depression reduction was maintained at 12 months. By comparison, short‐term (up to 12 weeks), but not longer‐term effectiveness was demonstrated for both pharmacological and psychological interventions. Conclusions Collaborative care interventions have newly emerged as multidisciplinary care delivery models, which may result in more long‐term depression remission. This review also updates previous findings of modest evidence for the effectiveness of both pharmacological and psychological interventions for threshold depression in cancer patients. Research designs focusing on combined treatments and delivery systems may best further the limited evidence‐base for the management of depression in cancer.