Kathleen Ell|Bin Xie|Brenda Quon|David I. Quinn|Megan Dwight?Johnson|Pey Jiuan Lee
Randomized Controlled Trial of Collaborative Care Management of Depression Among Low-Income Patients With Cancer
University of Southern California|University of Washington|University of Southern California|University of Washington|University of Southern California|University of Washington|University of Southern California|University of Washington|University of Southern California|University of Washington|University of Southern California|University of Washington
determine effectiveness alleviating depression among patients cancer adaptc collaborative care management major depression dysthymiastudy patients included 472 lowincome predominantly female hispanic patients cancer age 18 years major depression 49 dysthymia 5 46 patients randomly assigned intervention n 242 enhanced usual care euc n 230 intervention patients access 12 months depression clinical specialist supervised psychiatrist offered education structured psychotherapy maintenancerelapse prevention support psychiatrist prescribed antidepressant medications patients preferring assessed require medicationat 12 months 63 intervention patients 50 greater reduction depressive symptoms baseline assessed patient health questionnaire9 phq9 depression scale compared 50 euc patients odds ratio 198 95 ci 116 338 p 01 improvement also found 5point decrease phq9 score among 722 intervention patients compared 597 euc patients 199 95 ci 114 350 p 02 intervention patients also experienced greater rates depression treatment 723 v 104 euc patients p 0001 significantly better qualityoflife outcomes including socialfamily adjusted mean difference groups 27 95 ci 122 417 p 001 emotional adjusted mean difference 129 95 ci 026 222 p 01 functional adjusted mean difference 134 95 ci 008 259 p 04 physical wellbeing adjusted mean difference 279 95 ci 049 51 p 02adaptc collaborative care feasible results significant reduction depressive symptoms improvement quality life lower pain levels compared euc patients depressive disorders lowincome predominantly hispanic population public sector oncology clinics