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Manejo de la depresión en personas con cáncer (SMaRT oncología 1): un ensayo aleatorizado
Vanessa Strong1, Rachel Waters, Carina Hibberd
1University of Edinburgh Cancer Research Centre, Western General Hospital, Crewe Road, Edinburgh, UK.
Lancet (London, England)
|July 8, 2008
Resumen
Una intervención realizada por una enfermera redujo significativamente la depresión en pacientes con cáncer. Este modelo de Cuidado de la Depresión para Personas con Cáncer es factible, aceptable y rentable para el manejo del trastorno depresivo mayor en personas con afecciones médicas.
Área de la Ciencia:
- Oncología Oncología.
- La psiquiatría es la psiquiatría.
- Economía de la salud Economía de la salud
Sus antecedentes:
- El trastorno depresivo mayor (TDM) tiene un impacto significativo en la calidad de vida de los pacientes con cáncer.
- Existen pruebas limitadas para el manejo de MDD en pacientes médicamente complejos.
- Este estudio evaluó una intervención administrada por una enfermera para el MDD en pacientes con cáncer.
Objetivo del estudio:
- Evaluar la eficacia de una intervención compleja administrada por una enfermera para el trastorno depresivo mayor (TDM) en pacientes con cáncer.
- Para determinar la rentabilidad de esta intervención.
- Para evaluar el impacto de la intervención en la ansiedad, la fatiga, el dolor y el funcionamiento físico.
Principales métodos:
- Se realizó un ensayo aleatorizado en un centro regional de cáncer del Reino Unido.
- 200 pacientes ambulatorios con cáncer y MDD fueron asignados al azar a la atención habitual o a la atención habitual más la intervención.
- La intervención involucró un promedio de siete sesiones impartidas por una enfermera oncológica; el resultado primario fue la puntuación de depresión a los 3 meses.
Principales resultados:
- El grupo de intervención mostró una puntuación de depresión significativamente más baja a los 3 meses (diferencia ajustada: 0.34, IC del 95% 0.13-0.55).
- Este efecto antidepresivo se mantuvo a los 6 y 12 meses.
- La intervención mejoró la ansiedad y la fatiga, pero no el dolor o el funcionamiento físico; el costo fue de $ 10,556 por año de vida ajustado por calidad ganado.
Conclusiones:
- La intervención "Cuidado de la depresión para personas con cáncer" es un modelo factible y aceptable para el manejo de MDD en pacientes con cáncer.
- Este enfoque muestra una potencial rentabilidad para el manejo del trastorno depresivo mayor en pacientes dentro de servicios médicos especializados.
- Los hallazgos sugieren un modelo valioso para la atención integrada de la salud mental en entornos oncológicos.
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