Newby, T.A., Graff, J.N., Ganzini, L.K., & McDonagh, M.S. (2015). Interventions that may reduce depressive symptoms among prostate cancer patients: A systematic review and meta-analysis. Psycho-Oncology. Advance online publication. 

DOI Link

Purpose

PURPOSE: To analyze the effects of nonpharmacologic interventions for depression in patients with cancer
 
TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: Medline, PsycINFO, and Cochrane Collaboration
 
KEYWORDS: Prostatic neoplasms and depression or depressive disorder and adaptation; psychological; additional specific Medline terms were provided
 
INCLUSION CRITERIA: Randomized, controlled trials comparing any intervention to no treatment or placebo; patients with any stage of prostate cancer or studies in which a subgroup analysis of prostate cancer patients was done; reported statistical measures of depression outcomes
 
EXCLUSION CRITERIA: None identified

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 471
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Study quality was evaluated using components of methods of the Drug Effectiveness Review Project. The majority of studies were of poor or fair quality.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 10 for qualitative review (nine in meta-analysis)
  • TOTAL PATIENTS INCLUDED IN REVIEW = 1,131
  • SAMPLE RANGE ACROSS STUDIES: 21–389 patients
  • KEY SAMPLE CHARACTERISTICS: All patients had prostate cancer.  

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

The meta-analysis across all studies with all types of interventions showed a positive effect of intervention (p = 0.002). In four studies using exercise, there was no significant effect. Across three studies of psychosocial interventions, including psychotherapy and peer support, the was an overall significant effect (point estimate –0.961, p = 0.003). In two studies of educational interventions, there was no statistically significant effect.

Conclusions

The findings of this study suggest that psychosocial interventions can be effective in reducing depressive symptoms among patients with prostate cancer.

Limitations

The majority of studies included were of low quality. The authors stated that in multiple-arm studies, outcomes were only used in certain selected study arms. For each subanalysis, there were few individual studies. There were some discrepancies in the report regarding the number of studies included. Samples were mixed in terms of inclusion of patients who did or did not have clinically relevant depressive symptoms. Most studies were brief, and the long-term benefits of the interventions were not clear.

Nursing Implications

Although this analysis provides relatively limited evidence regarding the effectiveness of individual types of interventions, its findings do suggest that some intervention is more effective than doing nothing. Nurses need to identify patients with symptoms of depression and those at risk for depression and take action.

Legacy ID

5292