Reasons for Low Uptake of a Psychological Intervention offered to Cancer Survivors with Elevated Depressive Symptoms

van der Donk, L. J., Tovote, K. A., Links, T. P., Roodenburg, J. L. N., Kluin-Nelemans, J. C., Arts, H. J. G., Mul, V. E. M., van Ginkel, R. J., Baas, P. C., Hoff, C., Sanderman, R., Fleer, J. & Schroevers, M. J., Apr-2019, In : Psycho-oncology. 28, 4, p. 830-838 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

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. Due to 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 non-participation, adds to the debate about the feasibility and effiency of screening guidelines.

METHODS: 2,608 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 non-participation were carefully monitored.

RESULTS: 1937 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 non-participation were: non-response 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
Issue number4
Publication statusPublished - Apr-2019

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