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Doctor Doctor: Finding Answers to Depression Among the Underserved

Network - Winter 2009


Karen Anderson, Ph.D.

The prevalence of depression in patients with cancer is estimated to be 15% to 30%, a rate 3 to 5 times greater than in the general population. However, it is well documented that providers often fail to detect patients’ distress, and that patients often do not disclose it.

Minority patients with cancer are particularly at risk for inadequate assessment and treatment of depression. That is why Karen Anderson, Ph.D., associate professor in the Department of Symptom Research at
M. D. Anderson, has recently been awarded a grant from the Robert Wood Johnson Foundation for a study, “The Identification and Treatment of Depression in Underserved African-American and Latino Patients With Cancer.”

What are the specific aims of the study?

The specific aims of the project are twofold: 1) to evaluate a computer-automated telephone interactive voice response alert for improving treatment of depression in African-American and Latino patients with cancer, and 2) to determine the utility of the IVR system for identifying depression.

How does the IVR system work?

The IVR system is a computer- and telephone-based assessment system that allows patients to report their level of sadness or distress. The patients enrolled in the intervention group of this randomized study receive a weekly call from the IVR system. In turn, they use the keypads of their telephones to rate and record symptoms as they occur on a 0-10 scale — 0 meaning not affected at all, 10 as bad as you can imagine.

How will the study be carried out?

The study plans to recruit 166 African-American and Latino patients, who will be randomly assigned to the IVR alert intervention or to a control group. The IVR alert group will receive IVR calls each week for four months. For patients in the intervention group, the IVR system will alert providers when a patient’s reported level of sadness or distress reaches a designated threshold and also will prompt the providers to follow clinical practice guidelines. Patients in the control group will receive the current standard of care for the assessment and treatment of emotional symptoms.

What are the clinical practice guidelines for those who pass the threshold?

For patients in the intervention group who pass the threshold of reported sadness or distress, the providers will follow the guidelines for the assessment and treatment of cancer-related distress that were developed by the National Comprehensive Cancer Network (NCCN).

What other organizations are involved in the study?

While M. D. Anderson is the lead organization, it will work in collaboration with the Harris County Hospital District to develop interventions designed to eliminate disparities in cancer-related symptoms such as depression.

Who is funding the project?

“Finding Answers: Disparities Research for Change” is a national program of the Robert Wood Johnson Foundation housed at the University of Chicago. It has awarded more than $2.5 million to 10 organizations that work to eliminate racial and ethnic health care disparities in their communities in an effort to ensure that all Americans receive the care they deserve.

For more information about this study, call Karen Anderson, Ph.D., at 713-745-3470.


© 2014 The University of Texas MD Anderson Cancer Center