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Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms
Author(s) -
Donk Loek J.,
Tovote K. Annika,
Links Thera P.,
Roodenburg Jan L.N.,
KluinNelemans Johanna C.,
Arts Henriette J.G.,
Mul Veronique E.M.,
Ginkel Robert J.,
Baas Peter C.,
Hoff Christiaan,
Sanderman Robbert,
Fleer Joke,
Schroevers Maya J.
Publication year - 2019
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.5029
Subject(s) - medicine , psychological intervention , observational study , depressive symptoms , intervention (counseling) , randomized controlled trial , quality of life (healthcare) , depression (economics) , patient health questionnaire , cancer , physical therapy , psychiatry , family medicine , anxiety , nursing , economics , macroeconomics
Objective In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set‐up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines. Methods Two thousand six hundred eight medium‐ to long‐term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire‐9 (PHQ‐9). Those with moderate depressive symptoms (PHQ‐9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored. Results One thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial. Conclusion Of the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho‐oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.