Depression Screenings Improve Care for Patients With Cancer

New research suggests that conducting depression screenings for patients with newly diagnosed breast cancer can help to identify patients in need of behavioral health care.

According to a press release from Kaiser Permanente, incorporating mental distress screenings during cancer care have been historically difficult, despite the fact that these patients tend to be vulnerable to mental health challenges. With this in mind, researchers aimed to determine whether a process of incorporating depression screenings into routine clinical care might make a difference.

“Early identification and treatment for mental health issues is critical, yet depression and other mental health issues are often under-identified and undertreated in breast cancer patients,” said the study’s lead author, Erin E. Hahn, PhD, in the press release. “Our study showed that the use of implementation strategies to facilitate depression screening is highly effective and provided insights into how to create a sustainable program to help our cancer patients achieve the best possible health.”

To investigate this, the researchers separated medical oncology teams at different locations into 2 groups. In the first group, physicians and nurses received education about depression screening, regular feedback on their performance, and support in determining the best ways to add depression screenings into their workflows. The second group acted as the control group and received only education. Screenings were conducted using the Patient Health Questionnaire 9-item version (PHQ-9).

All patients diagnosed with new breast cancers who had a consultation with the medical oncology team between October 1, 2017, and September 30, 2018, were included in the study. Researchers enrolled 692 participants in the control group and 744 in the intervention group, with both groups similar in demographics and cancer characteristics.

According to the study, 80% of patients in the intervention group completed depression screening compared to less than 1% in the control group. Of the intervention group screenings, 10% scored in the range indicating the need for a referral to mental health services. Of those, 94% received referrals and 75% of those completed a visit with a mental health provider.

Furthermore, patients in the intervention group had significantly fewer clinic visits to the oncology departments and no difference in outpatient visits for primary care, urgent care, or emergency department services.

“The trial of this program was so successful that, with funding from our Care Improvement Research Team, we have rolled out depression screening initiatives across all our Kaiser Permanente medical oncology departments in Southern California,” Hahn said in the press release. “We are incorporating the lessons learned from the trial, particularly the importance of ongoing audit and feedback of performance and are encouraging our clinical teams to adapt the workflow to meet their needs.”

REFERENCE

Depression screening improves care for patients with cancer. News release. Kaiser Permanente; January 4, 2022. Accessed January 6, 2022. https://about.kaiserpermanente.org/our-story/health-research/news/depression-screening-breast-cancer-patients-jama