In a new study from Kaiser Permanente, researchers found depression screening for patients with newly diagnosed breast cancer was highly effective at identifying patients in need of behavioral health care.
It has been difficult historically to incorporate mental distress screening during cancer care when patients tend to be vulnerable to mental health challenges.
The team set out to determine if a process of incorporating depression screening into routine clinical care with support from researchers might make a difference.
They separated medical oncology teams at different locations into 2 groups.
In the first group, physicians and nurses received education about depression screening, regular feedback on their performance, and support in determining the best ways to add depression screening into their current workflow.
In the second group—the control group—physicians and nurses received only education. The screening was conducted using the Patient Health Questionnaire 9-item version, known as the PHQ-9.
80% of patients in the intervention group completed depression screening versus less than 1% in the control group.
Of intervention group screenings, 10% scored in the range indicating the need for referral to mental health services. Of those, 94% received referrals.
Of those referred, 75% completed a visit with a mental health provider.
Additionally, patients in the intervention group had much fewer clinic visits to the oncology departments, and no difference in outpatient visits for primary care, urgent care, and emergency department services.
The team says early identification and treatment for mental health issues is critical, yet depression and other mental health issues are often under identified and undertreated in breast cancer patients.
The study showed that the use of implementation strategies to facilitate depression screening is highly effective and provided insights into how to create a sustainable program to help our cancer patients achieve the best possible health.
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The study is published in JAMA and was conducted by Erin E. Hahn et al.
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