Patient and general practitioner preferences for the treatment of depression in patients with cancer: how, who, and where?
Hodges L., Butcher I., Kleiboer A., McHugh G., Murray G., Walker J., Wilson R., Sharpe M.
OBJECTIVE: The objective of this study was to determine and compare patient and general practitioner (GP) preferences for the treatment of depression in patients with cancer. METHODS: A treatment preference questionnaire was completed by 100 patients who had been diagnosed with both cancer and major depressive disorder and by 86 GPs who had had experience of at least 1 patient with cancer and depression. Participants were asked to rank options for how depression should be treated, who should deliver the treatment, and where treatment should occur. RESULTS: The top three preferences of patients and GPs for how depression should be treated differed (P<.001). Patients preferred talking treatment alone, whereas GPs preferred a combination of drug and talking treatment. Both patients and GPs preferred treatment to be given by the GP, with older patients having a stronger preference for this. Counselors and cancer nurses were also popular preferences; mental heath professionals were unpopular. The preferred place of treatment was primary care for both patients and GPs, although many patients preferred treatment in the cancer center. CONCLUSION: Effective and acceptable services for depressed cancer patients need to take patients and GP preferences into account. A model of service that allows a choice of initial treatment modality and collaborative care between primary care and cancer center nurse would meet this requirement.