Strong V et al. - In a study to assess the efficacy and cost of a nurse-delivered complex intervention that was designed to treat major depressive disorder in pts who have cancer, it was found that the intervention-Depression Care for People with Cancer-offers a model for the management of major depressive disorder in pts with cancer and other medical disorders who are attending specialist medical services that is feasible, acceptable, and potentially cost effective Methods
200 outpatients who had cancer with a prognosis of greater than 6 months and major depressive disorder were eligible and agreed to take part
Mean age was 56.6 years, and 71% were women
99 participants were randomly assigned to usual care, and 101 to usual care plus the intervention, with minimisation for sex, age, diagnosis, and extent of disease
The intervention was delivered by a cancer nurse at the centre over an average of 7 sessions
The primary outcome was the difference in mean score on the self-reported Symptom Checklist-20 depression scale (range 0 to 4) at 3 months after randomisation
Results
Primary outcome data were missing for 4 pts
For 196 pts for whom data was available at 3 months, the adjusted difference in mean Symptom Checklist-20 depression score, between those who received the intervention and those who did not, was 0.34
This treatment effect was sustained at 6 and 12 months
The intervention also improved anxiety and fatigue but not pain or physical functioning
It cost an additional US$10,556 per quality-adjusted life-year gained
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