Analysis of the likelihood of depression versus distress screening to identify need for intervention.

Authors

Valerie Csik

Valerie Pracilio Csik

Sidney Kimmel Cancer Center, Philadelphia, PA

Valerie Pracilio Csik , Emma Hannan , Lauren Waldman , Greg D. Garber , Brooke Worster

Organizations

Sidney Kimmel Cancer Center, Philadelphia, PA, Sidney Kimmel Cancer Center at Jefferson Health, Philadelphia, PA, Thomas Jefferson University Hospital, Philadelphia, PA

Research Funding

No funding received

Background: Psychosocial assessments are increasingly used to evaluate a patient-centered approach to quality cancer care delivery. Value-based oncology programs endorse screening metrics at every encounter. To comply with expectations of these programs, our cancer center utilizes two standardized tools: Patient Health Questionnaire (PHQ) to screen for depression at every encounter; National Comprehensive Cancer Network Distress Thermometer (NCCNDT) to screen for acute distress at clinically meaningful intervals. In 2021, oncology patients completed, on average, 5 annual appointments at Sidney Kimmel Cancer Center (SKCC), with a median appointment frequency of once every 19 days. Given the high encounter-per-patient ratio, we aimed to assess utility of frequent screening leading to supportive intervention. Methods: A retrospective analysis was conducted of medical oncology patients seeking care at SKCC with a completed depression and/or distress screening, as recorded in the patient’s electronic health record, between 1/1/2021 and 12/31/2021. This analysis intended to evaluate the percentage of patients whose scores indicate need for intervention. Patients who received more than one screening were attributed the highest score recorded during the measurement period. Results: A total 13,342 patients were screened at least once for either depression (n = 7,433), distress (n = 1,325), or both (n = 4,584). 3% of all patients screened ever met the intervention threshold (IT) for depression; 33% met the IT for distress. Of the patients who received both types of screenings, 31% met the IT for distress without meeting the threshold for depression. Those 1,418 patients would not have been referred for intervention through depression screening alone. Conclusions: This analysis highlights routine depression screening among a cancer population with a high encounter-per-patient ratio may not be sensitive in identifying need for supportive intervention. It also suggests that distress screening is more likely to lead to a supportive intervention than depression screening alone. This analysis combined with the anecdotal assessment by social workers supports the value of distress at clinically meaningful intervals over depression screening at each encounter.

Depression versus distress screening results.



Depression
Below IT (<10) Meets IT (≥10)
DistressMeets IT (≥4) 1418 (31%)145 (3%)
Below IT (<4)2964 (65%)57 (1%)

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Care Delivery and Regulatory Policy

Track

Care Delivery and Quality Care

Sub Track

Care Delivery

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 1544)

DOI

10.1200/JCO.2022.40.16_suppl.1544

Abstract #

1544

Poster Bd #

137

Abstract Disclosures

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