Depression screening and use of supportive care services in prostate cancer.

Abstract

219 Background: Patients with prostate cancer (PC) have high rates of depression (15-20%), which is associated with worse oncologic outcomes. The PHQ-9 is commonly used in depression screening, but men with depression may present differently than women, and male-specific screening tools such as the Gotland Male Depression Scale (GMDS) have also been developed and validated. The use of supportive care services in men with PC and depression is not well-described. Methods: Men with ≥1 Urology or Medical Oncology clinic visit for PC in the prior 6 months were emailed the PHQ-9 and GMDS every 60 days. Men who screened positive (score ≥10 on PHQ-9 or ≥13 on GMDS, consistent with moderate to severe depression) were contacted by phone to discuss the positive screen; during that conversation patients were offered a referral to an oncology social worker for a formal needs assessment and connection to supportive care services. Patient characteristics and use of supportive care services (palliative care, psychiatry, counseling, support groups, or spiritual health) at baseline and as a result of study screening were collected by survey and chart review. Results: Between 6/2021-12/2021, 201 men enrolled (Table). 184 completed ≥2 screens with mean follow-up 6.5 months (SD 1.3). 31 men (15.4%) had ≥1 positive PHQ-9 screen and 11 (5.5%) had ≥1 positive GMDS screen, 9 of whom also screened positive on the PHQ-9. Of the 33 men offered clinical social work referrals based on PHQ-9 or GMDS screening, 12 (36%) initially accepted and 7 (21%) ultimately met with social work. Of these 7 men, two ultimately received ongoing supportive counseling from social work, two were referred to support groups or peers in the community, and one was referred to financial services; the remaining two men were not followed longitudinally or referred to any services by the social worker, but were given the option to re-contact the social worker as needed. For the two patients who screened positive on the GMDS but not the PHQ-9, one declined social work referral, and one initially accepted but never scheduled an appointment. Conclusions: Use of supportive care services in men with PC was low, including when services were actively offered as a result of depression screening. Beyond the PHQ-9, the GMDS did not identify any men who engaged in supportive care services. More work is needed to optimally identify men with PC who may benefit from supportive care services and barriers to use.[Table: see text]