title: One-year follow-up of collaborative depression care for low-income, predominantly Hispanic patients with cancer.
abstract: OBJECTIVE
  This study assessed longer-term outcomes of low-income patients with cancer (predominantly female and Hispanic) after treatment in a collaborative model of depression care or in enhanced usual care.
  
  
  METHODS
  The randomized controlled trial, conducted in safety-net oncology clinics, recruited 472 patients with major depression symptoms. Patients randomly assigned to a 12-month intervention (a depression care manager and psychiatrist provided problem-solving therapy, antidepressants, and symptom monitoring and relapse prevention) or enhanced usual care (control group) were interviewed at 18 and 24 months after enrollment.
  
  
  RESULTS
  At 24 months, 46% of patients in the intervention group and 32% in the control group had a ≥50% decrease in depression score over baseline (odds ratio=2.09, 95% confidence interval=1.13-3.86; p=.02); intervention patients had significantly better social (p=.03) and functional (p=.01) well-being. Treatment receipt among intervention patients declined (72%, 21%, and 18% at 12, 18, and 24 months, respectively); few control group patients reported treatment receipt (10%, 6%, and 13%, respectively). Significant differences in receipt of counseling or antidepressants disappeared at 24 months. Depression recurrence was similar between groups (intervention, 36%; control, 39%). Among patients with depression recurrence, intervention patients were more likely to receive treatment after 12 months (34% versus 10%; p=.03). At 24 months, attrition (262 patients, 56%) did not vary by group; 22% were deceased, 20% declined further participation, and 14% could not be located.
  
  
  CONCLUSIONS
  Collaborative care reduced depression symptoms and enhanced quality of life; however, results call for ongoing depression symptom monitoring and treatment for low-income cancer survivors.
authors.affiliation: School of Social Work, University of Southern California, 669 W. 34th St., Los Angeles, CA 90089-0411, USA. ell@usc.edu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ell
authors.forename: Bin
authors.initials: B
authors.lastname: Xie
authors.forename: Suad
authors.initials: S
authors.lastname: Kapetanovic
authors.forename: David I
authors.initials: DI
authors.lastname: Quinn
authors.forename: Pey-Jiuan
authors.initials: PJ
authors.lastname: Lee
authors.forename: Anjanette
authors.initials: A
authors.lastname: Wells
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
mesh_terms: D002140:California; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000191:economics / Q000208:ethnology / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics / Q000523:psychology*; D010348:Patient Care Team; D017060:Patient Satisfaction; D011203:Poverty / Q000191:economics / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D055502:Secondary Prevention