***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The management of depression in patients with poor prognosis cancers , such as lung cancer , creates specific challenges . We aim ed to assess the efficacy of an integrated treatment programme for major depression  in patients with lung cancer compared with usual care . METHODS Symptom Management Research Trials ( SMaRT ) Oncology-3 is a parallel-group , multicentre , r and omised controlled trial . We enrolled patients with lung cancer and major depression from three cancer centres and their associated clinics in Scotl and , UK . Participants were r and omly assigned in a 1:1 ratio to the  depression care for people with lung cancer treatment programme or usual care by a data base software algorithm that used stratification ( by trial centre ) and minimisation ( by age , sex , and cancer type ) with allocation concealment . Depression care for people with lung cancer is a manualised , multicomponent collaborative care treatment that is systematic ally delivered by a team of cancer nurses and psychiatrists in collaboration with primary care physicians . Usual care is provided by primary care physicians . The primary outcome was depression severity ( on the Symptom Checklist Depression Scale [ SCL-20 ] , range 0 - 4 ) averaged over the patient 's time in the trial ( up to a maximum of 32 weeks ) . Trial statisticians and data collection staff were masked to treatment allocation , but patients and clinicians could not be masked to the allocations . Analyses were by intention to treat . This trial is registered with Current Controlled Trials , number IS RCT N75905964 . FINDINGS 142 participants were recruited between Jan 5 , 2009 , and Sept 9 , 2011 ; 68 were r and omly allocated to depression care for people with lung cancer and 74 to usual care . 43 ( 30 % ) of 142 patients had died by 32 weeks , all of which were cancer-related deaths . No intervention-related serious adverse events occurred . 131 ( 92 % ) of 142 patients provided outcome data ( 59 in the depression care for people with lung cancer group and 72 in the usual care group ) and were included in the intention-to-treat primary analysis . Average depression severity was significantly lower in patients allocated to depression care for people with lung cancer ( mean score on the SCL-20 1·24 [ SD 0·64 ] ) than in those allocated to usual care ( mean score 1·61 [ SD 0·58 ] ) ; difference -0·38 ( 95 % CI -0·58 to -0·18 ) ; st and ardised mean difference -0·62 ( 95 % CI -0·94 to -0·29 ) . Self-rated depression improvement , anxiety , quality of life , role functioning , perceived quality of care , and proportion of patients achieving a 12-week treatment response were also significantly better in the depression care for people with lung cancer group than in the usual care group . INTERPRETATION Our findings suggest that major depression can be treated effectively in patients with a poor prognosis cancer ; integrated depression care for people with lung cancer was substantially more efficacious than was usual care . Larger trials are now needed to estimate the effectiveness and cost-effectiveness of this care programme in this patient population , and further adaptation of the treatment will be necessary to address the unmet needs of patients with major depression and even shorter life expectancy . FUNDING Cancer Research UK and Chief Scientist Office of the Scottish Government BACKGROUND Depression is a highly prevalent , often recurring or persistent disorder . The majority of patients are initially seen and treated in primary care . Effective treatments are available , but possibilities for providing adequate follow-up care are often limited in this setting . This study assesses the effectiveness of primary -care-based enhanced treatment modalities on short-term patient outcomes . METHOD In a r and omized controlled trial we evaluated a psycho-educational self-management intervention .  We included 267 adult patients meeting criteria for a DSM-IV diagnosis of major depressive disorder , assessed by a structured psychiatric interview . Patients were r and omly assigned to : the Depression Recurrence Prevention ( DRP ) program ( n=112 ) ; a combination of the DRP program with psychiatric consultation ( PC+DRP , n=39 ) ; a combination with brief cognitive behavior therapy ( CBT+DRP , n=44 ) ; and care as usual ( CAU , n=72 ) . Follow-up assessment s were made at 3 months ( response 90 % ) and 6 months ( 85 % ) . RESULTS Patient acceptance of enhanced care was good . The mean duration of the index episode was 11 weeks ( S.D.=9.78 ) and similar in CAU and enhanced care . Recovery rate after 6 months was 67 % overall ; 17 % of all participants remained depressed for the entire 6-month period . CONCLUSION Enhanced care did not result in better short-term outcomes . We found no evidence that the DRP program was more effective than CAU and no indications for added beneficial effects of either the psychiatric evaluation or the CBT treatment to the basic format of the DRP program . Observed depression treatment rates in CAU were high Background Depression is common in primary care and is often unrecognized and untreated . Studies are needed to demonstrate the feasibility of implementing evidence -based depression care provided by primary health care workers ( PHCWs ) in sub-Saharan Africa . We carried out a pilot two-parallel arm cluster r and omized controlled trial of a package of care for depression in primary care . Methods Six primary health care centers ( PHCC ) in two Local Government Areas of Oyo State , South West Nigeria were r and omized into 3 intervention and 3 control clinics . Three PHCWs were selected for training from each of the participating clinics . The PHCWs from the intervention clinics were trained to deliver a manualized multicomponent stepped care intervention package for depression consisting of psychoeducation , activity scheduling , problem solving treatment and medication for severe depression . Providers from the control clinics delivered care as usual , enhanced by a refresher training on depression diagnosis and management . Outcome measures Patient ’s Health Question naire ( PHQ-9 ) , WHO quality of Life instrument ( WHOQOL-Bref ) and the WHO disability assessment schedule ( WHODAS ) were administered in the participants ’ home at baseline , 3 and 6 months . Results About 98 % of the consecutive attendees to the clinics agreed to have the screening interview . Of those screened , 284 ( 22.7 % ) were positive ( PHQ-9 score ≥ 8) and 234 gave consent for inclusion in the study : 165 from intervention and 69 from control clinics . The rates of eligible and consenting participants were similar in the control and intervention arms . In all 85.9 % ( 92.8 % in intervention and 83 % in control ) of the participants were successfully administered outcome assessment s at 6 months . The PHCWs had little difficulty in delivering the intervention package . At 6 months follow up , depression symptoms had improved in 73.0 % from the intervention arm compared to 51.6 % control . Compared to the mean scores at baseline , there was improvement in the mean scores on all outcome measures in both arms at six months . Conclusion The results provide support for the feasibility of conducting a fully-powered r and omized study in this setting and suggest that the instruments used may have the potential to detect differences between the arms . Trial registration numberIS RCT N46754188 ( ISRTCN registry at isrtcn.com ) ; registered 23 September 2013 , details of the pilot study added 12/02/2015 Background Evidence -based practice s design ed for large urban clinics are not necessarily portable into smaller isolated clinics . Implementing practice -based collaborative care for depression in smaller primary care clinics presents unique challenges because it is often not feasible to employ on-site psychiatrists . Objective The purpose of the Telemedicine Enhanced Antidepressant Management ( TEAM ) study was to evaluate a telemedicine-based collaborative care model adapted for small clinics without on-site psychiatrists . Design Matched sites were r and omized to the intervention or usual care . Participants Small VA Community-based outpatient clinics with no on-site psychiatrists , but access to telepsychiatrists .  In 2003–2004 , 395 primary care patients with PHQ9 depression severity scores ≥12 were enrolled , and followed for 12 months . Patients with serious mental illness and current substance dependence were excluded .  Measures Medication adherence , treatment response , remission , health status , health-related quality of life , and treatment satisfaction . Results The sample comprised mostly elderly , white , males with substantial physical and behavioral health comorbidity . At baseline , subjects had moderate depression severity (  Hopkins Symptom Checklist , SCL-20 = 1.8 ) , 3.7 prior depression episodes , and 67 % had received prior depression treatment . Multivariate analyses indicated that intervention patients were more likely to be adherent at both 6 ( odds ratio [ OR ] = 2.1 , p = .04 ) and 12 months ( OR = 2.7 , p = .01 ) . Intervention patients were more likely to respond by 6 months ( OR = 2.0 , p = .02 ) , and remit by 12 months ( OR = 2.4 , p = .02 ) . Intervention patients reported larger gains in mental health status and health-related quality of life , and reported higher satisfaction . Conclusions Collaborative care can be successfully adapted for primary care clinics without on-site psychiatrists using telemedicine technologies Background People with chronic depression are frequently lost from effective care , with result ing psychological , physical and social morbidity and considerable social and financial societal costs . This r and omised controlled trial will evaluate whether regular structured practice nurse review s lead to better mental health and social outcomes for these patients and will assess the cost-effectiveness of the structured review s compared to usual care . The hypothesis is that structured , pro-active care of patients with chronic depression in primary care will lead to a cost-effective improvement in medical and social outcomes when compared with usual general practitioner ( GP ) care . Methods / Design Participants were recruited from 42 general practice s throughout the United Kingdom . Eligible participants had to have a history of chronic major depression , recurrent major depression or chronic dsythymia confirmed using the Composite International Diagnostic Interview ( CIDI ) . They also needed to score 14 or above on the Beck Depression Inventory ( BDI-II ) at recruitment . Once consented , participants were r and omised to treatment as usual from their general practice ( controls ) or the practice nurse led intervention . The intervention includes a specially prepared education booklet and a comprehensive baseline assessment of participants ' mood and any associated physical and psycho-social factors , followed by regular 3 monthly review s by the nurse over the 2 year study period . At these appointments intervention participants ' mood will be review ed , together with their current pharmacological and psychological treatments and any relevant social factors , with the nurse suggesting possible amendments according to evidence based guidelines . This is a chronic disease management model , similar to that used for other long-term conditions in primary care . The primary outcome is the BDI-II , measured at baseline and 6 monthly by self-complete postal question naire . Secondary outcomes collected by self-complete question naire at baseline and 2 years include social functioning , quality of life and data for the economic analyses . Health service data will be collected from GP notes for the 24 months before recruitment and the 24 months of the study . Discussion 558 participants were recruited , 282 to the intervention and 276 to the control arm . The majority were recruited via practice data base search es using relevant READ codes . Trial registration IS RCT IMPORTANCE It is often difficult for members of the US military to access high- quality care for posttraumatic stress disorder ( PTSD ) and depression . OBJECTIVE To determine effectiveness of a central ly assisted collaborative telecare ( CACT ) intervention for PTSD and depression in military primary care . DESIGN , SETTING , AND PARTICIPANTS The STEPS-UP study ( Stepped Enhancement of PTSD Services Using Primary Care ) is a r and omized trial comparing CACT with usual integrated mental health care for PTSD or depression . Patients , mostly men in their 20s , were enrolled from 18 primary care clinics at 6 military installations from February 2012 to August 2013 with 12-month follow-up completed in October 2014 . INTERVENTIONS R and omization was to CACT ( n = 332 ) or usual care ( n = 334 ) . The CACT patients received 12 months of stepped psychosocial and pharmacologic treatment with nurse telecare management of caseloads , symptoms , and treatment . MAIN OUTCOMES AND MEASURES Primary outcomes were severity scores on the PTSD Diagnostic Scale ( PDS ; scored 0 - 51 ) and Symptom Checklist depression items ( SCL-20 ; scored 0 - 4 ) . Secondary outcomes were somatic symptoms , pain severity , health-related function , and mental health service use . RESULTS Of 666 patients , 81 % were male and the mean ( SD ) age was 31.1 ( 7.7 ) years . The CACT and usual care patients had similar baseline mean ( SD ) PDS PTSD ( 29.4 [ 9.4 ] vs 28.9 [ 8.9 ] ) and SCL-20 depression ( 2.1 [ 0.6 ] vs 2.0 [ 0.7 ] ) scores . Compared with usual care , CACT patients reported significantly greater mean ( SE ) 12-month decrease in PDS PTSD scores ( -6.07 [ 0.68 ] vs -3.54 [ 0.72 ] ) and SCL-20 depression scores -0.56 [ 0.05 ] vs -0.31 [ 0.05 ] ) . In the 
    Output:
    
Relapse is a significant risk amongst people treated for depression and interventions are needed that specifically address and minimise this risk .