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Improving the management of depression for patients at the end of life

The final year of life is a critical time for both quality of life and medical costs.

Depression is likely to affect both quality of life and health care costs in the last year of life, but there has been little research into effective interventions for depression that are integrated with palliative care services.

This project aims to first identify the nature, prevalence and current management of depression in patients being treated by a specialist palliative care service for one or more chronic medical illnesses, including cancer. We will then find out how well these psychiatric needs are currently being met and the barriers to achieving this by interviewing staff and patients.

Based on these findings, and on our previous research, we will (working with the newly commissioned Oxford University Hospitals Psychological Medicine service), develop a new approach to managing depression that is integrated with palliative care.

We will then pilot and refine the new approach to this aspect of palliative care. Finally we aim to conduct a randomised controlled trial to evaluate the effect of this new approach to care on quality of life, cost of care and place of death with that achieved by usual palliative care for patients with depression. 

Our team

Publications

Integrated collaborative care for comorbid major depression in patients with cancer (SMaRT Oncology-2): a multicentre randomised controlled effectiveness trial
Sharpe M, Walker J, Hansen CH, Martin P, Symeonides S, Gourley C, Wall L, Weller D, Murray G, the SMaRT Oncology-2 Team.
The Lancet 2014 doi:10.1016/S0140-6736(14)61231-9

Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicentre randomised controlled trial in patients with lung cancer
Walker J, Hansen CH, Martin P, Symeonides S, Gourley C, Wall L, Weller D, Murray G, Sharpe M, the SMaRT Oncology-3 Team.
The Lancet Oncology 2014 doi:10.1016/S1470-2045(14)70343-2

Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data
Walker J, Hansen CH, Martin P, Symeonides S, Ramessur R, Murray G, Sharpe M.
The Lancet Psychiatry 2014 doi:10.1016/S2215-0366(14)70313-X

Related research themes

Research to improve the care of those with a mental illness that is associated with physical illness.
Better management of medical-psychiatric multimorbidity