Ten percent of cancer patients have major depressive disorder. Major depression is known to reduce adherence to cancer treatment, impair quality of life and limit peoples return to normal activities, even after successful cancer treatment.
‘Depression Care for People with Cancer’ (DCPC) addresses this. DCPC integrates with traditional cancer care and provides both psychological and pharmacological depression treatment. It is delivered by a team of cancer nurses and specialist psychiatrists working with the patient’s GP.
DCPC has been found to substantially improve patients’ depression and quality of life in three clinical trials. It is recommended in the independent NHS England ‘Cancer Taskforce Report’ and is listed as an example of integrated care in a Kings’ Fund report.
Despite DCPC’s clinical and cost effectiveness and recommendations, we know that translating such treatments from clinical trial to routine practice is difficult and can often fail to realise its promise
 Duarte A, Walker J, Walker S, Richardson G, Hansen CH, Martin P, Murray G, Sculpher M, Sharpe M. Cost-effectiveness of integrated collaborative care for comorbid major depression in patients with cancer. Journal of psychosomatic research. 2015 Dec 31;79(6):465-70.
The CLAHRC funded ‘Depression in Cancer’ project addresses this ‘translational gap’; taking the findings from clinical trials and working out how best to implement them in the real-world setting of the NHS – the first step towards wider roll out across the NHS and maximising patient benefit.
This solution developed by CLAHRC researchers, with external funding from Cancer Research UK, comprises a screening system, for identifying symptoms of depression in cancer patients, and the DCPC treatment approach itself. It is being implemented and evaluated in the Oxford Cancer Centre.
Additionally, the implementation of this system allows us to ask patients about other cancer symptoms before their oncology appointments, ensuring that their needs are addressed and that consultations are both focused and efficient.
A steering committee including patients and carers was also set up to help guide the implementation.
This important study will lead to the development of an implementation toolkit for DCPC that can be used throughout the NHS, providing effective depression care for patients with cancer across the UK and potential cost-savings to the NHS.
The project was used as part of an exemplar case study of embedding mental health services in acute settings by NHS England.
Additionally, there are plans to implement the new service model developed through the CLAHRC in a centre in Australia which will add to our knowledge of key requirements for successful implementation and reinforces the impact of this CLAHRC research both nationally and internationally.