Gaps in Depression Symptom Management for Patients With Head and Neck Cancer.
cancer
depression
mental health
patient-reported outcomes
psychiatric utilization
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
revised:
27
12
2022
received:
08
11
2022
accepted:
16
01
2023
medline:
20
9
2023
pubmed:
8
2
2023
entrez:
7
2
2023
Statut:
ppublish
Résumé
To understand practice patterns and identify care gaps within a large-scale depression screening program for patients with head and neck cancer (HNC). Retrospective cohort study. This was a population-based study of adults diagnosed with a HNC between January 2007 and October 2020. Each patient was observed from time of first symptom assessment until end of study date, or death. The exposure of interest was a positive depressive symptom screen on the Edmonton Symptom Assessment System (ESAS). Outcomes of interest included psychiatry/psychology assessment, social work referral, or palliative care assessment. Cause specific hazard models with a time-varying exposure were used to investigate the exposure-outcome relationships. Of 14,054 patients with HNC, 9016 (64.2%) reported depressive symptoms on at least one ESAS assessment. Within 60 days of first reporting depressive symptoms, 223 (2.7%) received a psychiatry assessment, 646 (7.9%) a social work referral, and 1131 (13.9%) a palliative care assessment. Rates of psychiatry/psychology assessment (HR 3.15 [95% CI 2.67-3.72]), social work referral (HR 1.83 [95% CI 1.64-2.02]), and palliative care assessment (HR 2.34 [95% CI 2.19-2.50]) were higher for those screening positive for depression. Certain patient populations were less likely to receive an assessment including the elderly, rural residents, and those without a prior psychiatric history. A high proportion of head and neck patients report depressive symptoms, though this triggers a referral in a small number of cases. These data highlight areas for improvement in depression screening care pathways. 3 Laryngoscope, 133:2638-2646, 2023.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2638-2646Subventions
Organisme : CIHR
Pays : Canada
Informations de copyright
© 2023 The American Laryngological, Rhinological and Otological Society, Inc.
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