title: The Indiana Cancer Pain and Depression (INCPAD) trial Design of a telecare management intervention for cancer-related symptoms and baseline characteristics of study participants.
abstract: OBJECTIVE
  Pain and depression are two of the most prevalent and treatable cancer-related symptoms, each present in at least 20-30% of oncology patients. Both symptoms are frequently either unrecognized or undertreated, however. This article describes a telecare management intervention delivered by a nurse-psychiatrist team that is designed to improve recognition and treatment of pain and depression. The enrolled sample is also described.
  
  
  METHODS
  The Indiana Cancer Pain and Depression study is a National Cancer Institute-sponsored randomized clinical trial. Four hundred five patients with cancer-related pain and/or clinically significant depression from 16 urban or rural oncology practices throughout Indiana have been enrolled and randomized to either the intervention group or to a usual-care control group. Intervention patients receive centralized telecare management coupled with automated home-based symptom monitoring. Outcomes will be assessed at 1, 3, 6 and 12 months by research assistants blinded to treatment arms.
  
  
  RESULTS
  Of 4465 patients screened, 2185 (49%) endorsed symptoms of pain or depression. Of screen-positive patients, about one-third were ineligible (most commonly due to pain or depression not meeting severity thresholds or to pain that is not related to cancer). Of the 405 patients enrolled, 32% have depression only, 24% have pain only and 44% have both depression and pain. At baseline, participants reported an average of 16.8 days out of the past 4 weeks during which they were confined to bed or had to reduce their usual activities by > or =50% due to pain or depression. Also, 176 (44%) reported being unable to work due to health reasons.
  
  
  CONCLUSIONS
  When completed, the Indiana Cancer Pain and Depression trial will test whether centralized telecare management coupled with automated home-based symptom monitoring improves outcomes in cancer patients with depression and/or pain. Findings will be important for both oncologists and mental health clinicians confronted with oncology patients' depression or pain.
authors.affiliation: Department of Medicine, Indiana University, Indianapolis, IN 46202, USA. kkroenke@regenstrief.org
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.forename: Dale
authors.initials: D
authors.lastname: Theobald
authors.forename: Kelli
authors.initials: K
authors.lastname: Norton
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sanders
authors.forename: Susan
authors.initials: S
authors.lastname: Schlundt
authors.forename: Stephanie
authors.initials: S
authors.lastname: McCalley
authors.forename: Pamela
authors.initials: P
authors.lastname: Harvey
authors.forename: Karen
authors.initials: K
authors.lastname: Iseminger
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Morrison
authors.forename: Janet S
authors.initials: JS
authors.lastname: Carpenter
authors.forename: Dawana
authors.initials: D
authors.lastname: Stubbs
authors.forename: Rakeva
authors.initials: R
authors.lastname: Jacks
authors.forename: Caroline
authors.initials: C
authors.lastname: Carney-Doebbeling
authors.forename: Jingwei
authors.initials: J
authors.lastname: Wu
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*
chemical_list: D000700:Analgesics; D000928:Antidepressive Agents