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Randomized Controlled Trial
. 2009 May-Jun;31(3):240-53.
doi: 10.1016/j.genhosppsych.2009.01.007. Epub 2009 Apr 5.

The Indiana Cancer Pain and Depression (INCPAD) trial Design of a telecare management intervention for cancer-related symptoms and baseline characteristics of study participants

Kurt Kroenke  1 , Dale Theobald, Kelli Norton, Rebecca Sanders, Susan Schlundt, Stephanie McCalley, Pamela Harvey, Karen Iseminger, Gwendolyn Morrison, Janet S Carpenter, Dawana Stubbs, Rakeva Jacks, Caroline Carney-Doebbeling, Jingwei Wu, Wanzhu Tu
Affiliations
Randomized Controlled Trial

The Indiana Cancer Pain and Depression (INCPAD) trial Design of a telecare management intervention for cancer-related symptoms and baseline characteristics of study participants

Kurt Kroenke et al. Gen Hosp Psychiatry. 2009 May-Jun.

Abstract

Objective: Pain and depression are two of the most prevalent and treatable cancer-related symptoms, each present in at least 20-30% of oncology patients. Both symptoms are frequently either unrecognized or undertreated, however. This article describes a telecare management intervention delivered by a nurse-psychiatrist team that is designed to improve recognition and treatment of pain and depression. The enrolled sample is also described.

Methods: The Indiana Cancer Pain and Depression study is a National Cancer Institute-sponsored randomized clinical trial. Four hundred five patients with cancer-related pain and/or clinically significant depression from 16 urban or rural oncology practices throughout Indiana have been enrolled and randomized to either the intervention group or to a usual-care control group. Intervention patients receive centralized telecare management coupled with automated home-based symptom monitoring. Outcomes will be assessed at 1, 3, 6 and 12 months by research assistants blinded to treatment arms.

Results: Of 4465 patients screened, 2185 (49%) endorsed symptoms of pain or depression. Of screen-positive patients, about one-third were ineligible (most commonly due to pain or depression not meeting severity thresholds or to pain that is not related to cancer). Of the 405 patients enrolled, 32% have depression only, 24% have pain only and 44% have both depression and pain. At baseline, participants reported an average of 16.8 days out of the past 4 weeks during which they were confined to bed or had to reduce their usual activities by > or =50% due to pain or depression. Also, 176 (44%) reported being unable to work due to health reasons.

Conclusions: When completed, the Indiana Cancer Pain and Depression trial will test whether centralized telecare management coupled with automated home-based symptom monitoring improves outcomes in cancer patients with depression and/or pain. Findings will be important for both oncologists and mental health clinicians confronted with oncology patients' depression or pain.

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Figures

Figure 1
Figure 1
Conceptual Model underlying INCPAD Trial.
Figure 2
Figure 2
Participant Flow Diagram in INCPAD Trial
See this image and copyright information in PMC

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