title: Oncology professionals' views on the use of antidepressants in cancer patients: a qualitative interview study.
abstract: OBJECTIVE
  Emotional distress, including depression, is an important issue for cancer patients and their families. Guidelines recommend the use of antidepressant drugs (ADs) for the management of depression in cancer. This study explores the views of oncology professionals about the inclusion of ADs in treatment plans.
  
  
  METHODS
  Semi-structured interview study. Data were analysed using framework analysis.
  
  
  METHODS
  A specialist cancer centre and six district general hospitals across the Yorkshire Cancer Network.
  
  
  METHODS
  18 randomly selected professionals from lung, breast, urology and colorectal cancer teams: oncologists (n=8), surgeons (n=3), clinical nurse specialists (n=2) and ward nurses (n=5).
  
  
  RESULTS
  Three main themes emerged relating to professionals' attitudes, knowledge and behaviour. Positive attitudes were primarily expressed by nurses. However, negative views were expressed about the potential for over-reliance on ADs, and their use constituting 'giving in'. Doctors reported a lack of confidence in the use of and knowledge about ADs with an associated reluctance to prescribe. The general practitioner (GP) was regarded as the most appropriate professional to prescribe ADs.
  
  
  CONCLUSIONS
  Cancer professionals highlighted a need for training in the appropriate use of ADs. Further, this research suggests that negative attitudes towards antidepressants may be a factor in their exclusion from treatment plans. The GP is seen to have a key prescribing role for AD therapy; however, it is unclear whether the GPs is asked to do this. This research raises questions about the adequacy of ADs in cancer care and to what extent the GP is able to meet this need.
authors.affiliation: Cancer Research UK Psychosocial Oncology and Clinical Practice Research Group, St James Institute of Oncology, University of Leeds, Leeds, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Holch
authors.forename: Kate L
authors.initials: KL
authors.lastname: Absolom
authors.forename: Simon
authors.initials: S
authors.lastname: Pini
authors.forename: Kate M
authors.initials: KM
authors.lastname: Hill
authors.forename: Alan
authors.initials: A
authors.lastname: Liu
authors.forename: Michael
authors.initials: M
authors.lastname: Sharpe
authors.forename: Alison
authors.initials: A
authors.lastname: Richardson
authors.forename: Christian
authors.initials: C
authors.lastname: Hosker
authors.forename: Galina
authors.initials: G
authors.lastname: Velikova
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D003863:Depression / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008495:Medical Oncology; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D009720:Nurse Clinicians; D009859:Oncology Nursing; D036301:Qualitative Research; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*
chemical_list: D000928:Antidepressive Agents