Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms

Loek J. van der Donk* (Corresponding Author), K. Annika Tovote, Thera P. Links, Jan L.N. Roodenburg, Johanna C. Kluin-Nelemans, Henriette J.G. Arts, Veronique E.M. Mul, Robert J. van Ginkel, Peter C. Baas, Christiaan Hoff, Robbert Sanderman, Joke Fleer, Maya J. Schroevers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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Abstract

Objective: In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set-up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines. Methods: Two thousand six hundred eight medium- to long-term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Those with moderate depressive symptoms (PHQ-9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored. Results: One thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial. Conclusion: Of the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho-oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.

Original languageEnglish
Pages (from-to)830-838
Number of pages9
JournalPsycho-oncology
Volume28
Issue number4
Early online date14 Feb 2019
DOIs
Publication statusPublished - 1 Apr 2019

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Survivors
Depression
Psychology
Neoplasms
Guidelines
Standard of Care
Early Detection of Cancer
Observational Studies
Health
Therapeutics

Keywords

  • UT-Hybrid-D
  • cancer survivors
  • consecutive screening
  • CONSORT
  • depression
  • oncology
  • randomized controlled trial
  • recruitment
  • screening
  • screening guidelines
  • cancer

Cite this

van der Donk, L. J., Tovote, K. A., Links, T. P., Roodenburg, J. L. N., Kluin-Nelemans, J. C., Arts, H. J. G., ... Schroevers, M. J. (2019). Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms. Psycho-oncology, 28(4), 830-838. https://doi.org/10.1002/pon.5029
van der Donk, Loek J. ; Tovote, K. Annika ; Links, Thera P. ; Roodenburg, Jan L.N. ; Kluin-Nelemans, Johanna C. ; Arts, Henriette J.G. ; Mul, Veronique E.M. ; van Ginkel, Robert J. ; Baas, Peter C. ; Hoff, Christiaan ; Sanderman, Robbert ; Fleer, Joke ; Schroevers, Maya J. / Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms. In: Psycho-oncology. 2019 ; Vol. 28, No. 4. pp. 830-838.
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title = "Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms",
abstract = "Objective: In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set-up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines. Methods: Two thousand six hundred eight medium- to long-term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Those with moderate depressive symptoms (PHQ-9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored. Results: One thousand thirty seven survivors (74.3{\%}) returned the questionnaire, with 147 (7.6{\%}) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3{\%}) were ineligible, including 26 survivors (17.7{\%}) already receiving treatment and another 44 survivors (30.0{\%}) reporting no need for treatment. Only 25 survivors (1.0{\%}) participated in the trial. Conclusion: Of the approached survivors for screening, only 1{\%} was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho-oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.",
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van der Donk, LJ, Tovote, KA, Links, TP, Roodenburg, JLN, Kluin-Nelemans, JC, Arts, HJG, Mul, VEM, van Ginkel, RJ, Baas, PC, Hoff, C, Sanderman, R, Fleer, J & Schroevers, MJ 2019, 'Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms', Psycho-oncology, vol. 28, no. 4, pp. 830-838. https://doi.org/10.1002/pon.5029

Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms. / van der Donk, Loek J. (Corresponding Author); Tovote, K. Annika; Links, Thera P.; Roodenburg, Jan L.N.; Kluin-Nelemans, Johanna C.; Arts, Henriette J.G.; Mul, Veronique E.M.; van Ginkel, Robert J.; Baas, Peter C.; Hoff, Christiaan; Sanderman, Robbert; Fleer, Joke; Schroevers, Maya J.

In: Psycho-oncology, Vol. 28, No. 4, 01.04.2019, p. 830-838.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms

AU - van der Donk, Loek J.

AU - Tovote, K. Annika

AU - Links, Thera P.

AU - Roodenburg, Jan L.N.

AU - Kluin-Nelemans, Johanna C.

AU - Arts, Henriette J.G.

AU - Mul, Veronique E.M.

AU - van Ginkel, Robert J.

AU - Baas, Peter C.

AU - Hoff, Christiaan

AU - Sanderman, Robbert

AU - Fleer, Joke

AU - Schroevers, Maya J.

N1 - Wiley deal

PY - 2019/4/1

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N2 - Objective: In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set-up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines. Methods: Two thousand six hundred eight medium- to long-term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Those with moderate depressive symptoms (PHQ-9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored. Results: One thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial. Conclusion: Of the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho-oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.

AB - Objective: In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set-up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines. Methods: Two thousand six hundred eight medium- to long-term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Those with moderate depressive symptoms (PHQ-9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored. Results: One thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial. Conclusion: Of the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho-oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.

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KW - cancer survivors

KW - consecutive screening

KW - CONSORT

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KW - oncology

KW - randomized controlled trial

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KW - screening

KW - screening guidelines

KW - cancer

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DO - 10.1002/pon.5029

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van der Donk LJ, Tovote KA, Links TP, Roodenburg JLN, Kluin-Nelemans JC, Arts HJG et al. Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms. Psycho-oncology. 2019 Apr 1;28(4):830-838. https://doi.org/10.1002/pon.5029