TY - JOUR
KW - California
KW - Combined Modality Therapy
KW - Depressive Disorder/economics/ethnology/etiology/therapy
KW - Female
KW - Follow-Up Studies
KW - Hispanic Americans/psychology
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasms/economics/psychology
KW - Patient Care Team
KW - Patient Satisfaction
KW - Poverty/economics/psychology
KW - Psychiatric Status Rating Scales
KW - Quality of Life
KW - Recurrence/prevention & control
AU - K. Ell
AU - B. Xie
AU - S. Kapetanovic
AU - D. I. Quinn
AU - P. J. Lee
AU - A. Wells
AU - C. P. Chou
A1 - 
AB - OBJECTIVE: This study assessed longer-term outcomes of low-income patients with cancer (predominantly female and Hispanic) after treatment in a collaborative model of depression care or in enhanced usual care. METHODS: The randomized controlled trial, conducted in safety-net oncology clinics, recruited 472 patients with major depression symptoms. Patients randomly assigned to a 12-month intervention (a depression care manager and psychiatrist provided problem-solving therapy, antidepressants, and symptom monitoring and relapse prevention) or enhanced usual care (control group) were interviewed at 18 and 24 months after enrollment. RESULTS: At 24 months, 46% of patients in the intervention group and 32% in the control group had a >/=50% decrease in depression score over baseline (odds ratio=2.09, 95% confidence interval=1.13-3.86; p=.02); intervention patients had significantly better social (p=.03) and functional (p=.01) well-being. Treatment receipt among intervention patients declined (72%, 21%, and 18% at 12, 18, and 24 months, respectively); few control group patients reported treatment receipt (10%, 6%, and 13%, respectively). Significant differences in receipt of counseling or antidepressants disappeared at 24 months. Depression recurrence was similar between groups (intervention, 36%; control, 39%). Among patients with depression recurrence, intervention patients were more likely to receive treatment after 12 months (34% versus 10%; p=.03). At 24 months, attrition (262 patients, 56%) did not vary by group; 22% were deceased, 20% declined further participation, and 14% could not be located. CONCLUSIONS: Collaborative care reduced depression symptoms and enhanced quality of life; however, results call for ongoing depression symptom monitoring and treatment for low-income cancer survivors.
BT - Psychiatric services (Washington, D.C.)
C5 - Healthcare Disparities
CP - 2
CY - United States
DO - 10.1176/appi.ps.62.2.162
IS - 2
JF - Psychiatric services (Washington, D.C.)
N2 - OBJECTIVE: This study assessed longer-term outcomes of low-income patients with cancer (predominantly female and Hispanic) after treatment in a collaborative model of depression care or in enhanced usual care. METHODS: The randomized controlled trial, conducted in safety-net oncology clinics, recruited 472 patients with major depression symptoms. Patients randomly assigned to a 12-month intervention (a depression care manager and psychiatrist provided problem-solving therapy, antidepressants, and symptom monitoring and relapse prevention) or enhanced usual care (control group) were interviewed at 18 and 24 months after enrollment. RESULTS: At 24 months, 46% of patients in the intervention group and 32% in the control group had a >/=50% decrease in depression score over baseline (odds ratio=2.09, 95% confidence interval=1.13-3.86; p=.02); intervention patients had significantly better social (p=.03) and functional (p=.01) well-being. Treatment receipt among intervention patients declined (72%, 21%, and 18% at 12, 18, and 24 months, respectively); few control group patients reported treatment receipt (10%, 6%, and 13%, respectively). Significant differences in receipt of counseling or antidepressants disappeared at 24 months. Depression recurrence was similar between groups (intervention, 36%; control, 39%). Among patients with depression recurrence, intervention patients were more likely to receive treatment after 12 months (34% versus 10%; p=.03). At 24 months, attrition (262 patients, 56%) did not vary by group; 22% were deceased, 20% declined further participation, and 14% could not be located. CONCLUSIONS: Collaborative care reduced depression symptoms and enhanced quality of life; however, results call for ongoing depression symptom monitoring and treatment for low-income cancer survivors.
PP - United States
PY - 2011
SN - 1557-9700; 1075-2730
SP - 162
EP - 170
EP - 
T1 - One-year follow-up of collaborative depression care for low-income, predominantly Hispanic patients with cancer
T2 - Psychiatric services (Washington, D.C.)
TI - One-year follow-up of collaborative depression care for low-income, predominantly Hispanic patients with cancer
U1 - Healthcare Disparities
U2 - 21285094
U3 - 10.1176/appi.ps.62.2.162
VL - 62
VO - 1557-9700; 1075-2730
Y1 - 2011
ER -