BACKGROUND: There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of best practice recommendations for the European Palliative Care Research Collaborative clinical practice guideline on managing depression in palliative care. METHODS: 18 members of an international, multi-professional expert group completed a structured questionnaire in two rounds, rating their agreement with proposed items on a scale from 0-10 and annotating with additional comments. The median and range were calculated to give a statistical average of the experts' ratings. RESULTS: There was contention regarding the benefits of screening, with 'routine informal asking' (median 8.5 (0-10)) rated more highly than formal screening tools such as the Hospital Anxiety and Depression Scale (median 7.0 (1-10). Mirtazapine (median 9 (7-10) and citalopram (median 9 (5-10) were the considered the best choice of antidepressant and cognitive behavioural therapy (median 9.0 (3-10) the best choice of psychological therapy. CONCLUSIONS: The range of expert ratings was broad, indicating discordance in the views of experts. Direct comparative data from randomised controlled trials are needed to strengthen the evidence-base and achieve clarity on how best to detect and treat depression in this setting.
BACKGROUND: There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of best practice recommendations for the European Palliative Care Research Collaborative clinical practice guideline on managing depression in palliative care. METHODS: 18 members of an international, multi-professional expert group completed a structured questionnaire in two rounds, rating their agreement with proposed items on a scale from 0-10 and annotating with additional comments. The median and range were calculated to give a statistical average of the experts' ratings. RESULTS: There was contention regarding the benefits of screening, with 'routine informal asking' (median 8.5 (0-10)) rated more highly than formal screening tools such as the Hospital Anxiety and Depression Scale (median 7.0 (1-10). Mirtazapine (median 9 (7-10) and citalopram (median 9 (5-10) were the considered the best choice of antidepressant and cognitive behavioural therapy (median 9.0 (3-10) the best choice of psychological therapy. CONCLUSIONS: The range of expert ratings was broad, indicating discordance in the views of experts. Direct comparative data from randomised controlled trials are needed to strengthen the evidence-base and achieve clarity on how best to detect and treat depression in this setting.
Authors: Scott A Irwin; Sanjai Rao; Kim Bower; Joanna Palica; Sanjay S Rao; Jeanne E Maglione; Matthew Soskins; Amy E Betterton; Frank D Ferris Journal: J Palliat Med Date: 2008-03 Impact factor: 2.947
Authors: Patricia D Biondo; Cheryl L Nekolaichuk; Carla Stiles; Robin Fainsinger; Neil A Hagen Journal: Support Care Cancer Date: 2007-10-30 Impact factor: 3.603
Authors: Adam E Singer; Daniella Meeker; Joan M Teno; Joanne Lynn; June R Lunney; Karl A Lorenz Journal: J Palliat Med Date: 2016-07-25 Impact factor: 2.947
Authors: Xavier Busquet-Duran; Eva Maria Jiménez-Zafra; Magda Tura-Poma; Olga Bosch-de la Rosa; Anna Moragas-Roca; Susana Martin-Moreno; Emilio Martínez-Losada; Silvia Crespo-Ramírez; Lola Lestón-Lado; Núria Salamero-Tura; Joana Llobera-Estrany; Núria Oriol-Peregrina; Eduard Moreno-Gabriel; Josep Maria Manresa-Domínguez; Pere Torán-Monserrat Journal: Healthcare (Basel) Date: 2021-02-04
Authors: Wei Lee; Sungwon Chang; Michelle DiGiacomo; Brian Draper; Meera R Agar; David C Currow Journal: BMC Palliat Care Date: 2022-01-16 Impact factor: 3.234