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- Title
Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process.
- Authors
Shaw, Joanne; Price, Melanie; Clayton, Josephine; Grimison, Peter; Shaw, Tim; Rankin, Nicole; Butow, Phyllis; Shaw, Joanne M; Price, Melanie A; Clayton, Josephine M; Butow, Phyllis N
- Abstract
<bold>Purpose: </bold>People with cancer and their families experience high levels of psychological morbidity. However, many cancer services do not routinely screen patients for anxiety and depression, and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context.<bold>Methods: </bold>A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Co-operative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point Likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the Likert scale.<bold>Results: </bold>Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after two Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings.<bold>Conclusions: </bold>This study identified a core set of evidence- and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.
- Subjects
AUSTRALIA; MENTAL health of cancer patients; ANXIETY risk factors; ANXIETY diagnosis; DELPHI method; DISEASE management; ANXIETY treatment; DIAGNOSIS of mental depression; MENTAL depression; THERAPEUTICS; ANXIETY; TUMORS &; psychology; ANXIETY disorders treatment; ANXIETY disorders; CONSENSUS (Social sciences); MEDICAL protocols; RESEARCH; DIAGNOSIS; PSYCHOLOGY
- Publication
Supportive Care in Cancer, 2016, Vol 24, Issue 1, p33
- ISSN
0941-4355
- Publication type
journal article
- DOI
10.1007/s00520-015-2742-5