Oncology Care Model-Related Increases in Screening for Depression and Pain and Patient-Reported Symptoms

Many patients with cancer experience pain or depression. The Centers for Medicare & Medicaid Services' Oncology Care Model (OCM) included practice-reported quality measures aiming to improve screening and management of pain and depression. We described changes over time and assessed concurrent changes in patient-reported symptoms over time.

We studied patients receiving chemotherapy at OCM-participating practices. We evaluated practice-reported information about screening and management of pain and depression and patient experience survey data collected quarterly during 2017-2022. We assessed changes in practice-reported rates of screening and management of pain and depression. We also estimated time trends in patient-reported symptoms of pain and emotional problems, such as anxiety and depression, as well as receipt of help for these problems, using a spline function at the start of the COVID-19 public health emergency, adjusting for patient and practice characteristics.

Practice-reported rates of pain screening and management improved from 76.5% to 92.6% from 2017 to 2022; depression screening and management rates improved from 56.6% to 81.7%. Concurrent assessments of patient-reported pain (-0.2 percentage points (pp)/quarter; P = .002) and emotional problems (-0.1 pp/quarter; P = .001) decreased slightly pre-COVID; trends for both symptoms were stable during COVID-19 (P > .20). Among patients reporting pain or emotional problems, there were slight decreases in reports of receiving help with these symptoms from their cancer care team before and during COVID-19 (all P < .06).

Despite substantial practice-reported increases in screening for pain and depression, concurrently collected measures of patient-reported pain and emotional problems declined very slightly and patient reports of receiving help from their cancer care team for these symptoms did not improve. Strategies beyond screening may be needed to better address pain and depression among patients receiving cancer treatment.