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Reducing Depression in Post-Treatment Cancer Survivors
There may be more effective treatment options when it comes to managing depression symptoms among post-treatment cancer survivors, according to a study by Jane McKusker, MD, DrPH, St. Mary’s Research Centre, Montreal, QC, Canada (J Clin Oncol. 2021 Feb 8. Epub ahead of print).
In order to examine the effectiveness of CanDirect, a novel telephone-supported depression self-care intervention, compared to usual care (UC), Dr McCusker and colleagues conducted a randomized trial that identified 245 patients between September 2016 to October 2018 who had completed cancer treatment within the past 10 years and had mild-moderate depressive symptoms with or without major depression.
The primary end point was depression severity, which was administered at baseline, 3 and 6 months, as assessed by the Center for Epidemiological Studies-Depression scale (CES-D). Nearly 90% (n = 218) of patients completed the primary outcome at 6 months.
Patients were randomly assigned to CanDirect plus UC (n = 121) or UC alone (n = 124). At 6 months, CanDirect participants reported less severe depression symptoms on the CES-D than UC participants (ES, 0.61; 95% CI, 0.33-0.88). CanDirect patients also had significantly greater quality of life, lower anxiety, greater activation, and lower rates of depression diagnosis, compared with UC. The adjusted effect size was 0.61 (95% CI, 0.33-0.88); the number needed to treat was 4.8 (95% CI, 3.0-12.6).
In an exploratory analysis that suggested sex was a modifier of the primary outcome (P = .03), the intervention was less effective in men (ES, 0.12; 95% CI, -0.45-0.69).
Findings suggest that CanDirect is an effective, clinically meaningful and sustainable method of treating cancer survivors with mild-moderate depression.—Emily Bader
