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Table 3 Collaborative Care Intervention Components

From: Is care really shared? A systematic review of collaborative care (shared care) interventions for adult cancer patients with depression

Authors (year) Care Co-ordinator General Practitioner Oncologist Psychiatrist Interdisciplinary Communication Intervention Training Fidelity Assessment
Dwight-Johnson [35] (2005) Social workers (CDCS) carry out the majority of treatment: problem solving treatment (PST); patient navigation/case management; monitoring, follow up. No role antidepressant prescribing Advice to oncologist; medication follow up; bi-weekly supervision to CDCS. CDCS provides feedback to oncologist and psychiatrist. Oncologist provided with two 1-h education sessions by psychiatrist on depression. Given summarised pocket reference guides. Not reported
Strong [34] (2008) Nurse - psychoeducation & PST, patient monitoring, communication, liaison between patient, psychiatrist &GP Antidepressant Prescribing No role defined Supervise treatment;
Review non-responders; prescribing advisory role. Weekly nurse supervision.
Nurse contacted GP for medication initiation / change and advice from the psychiatrist Nurse: written materials, tutorials and supervised practice over 3 months. All nurse sessions video recorded; 10% assessed for adherence
Ell [37] (2008) Social workers (CDCS) carry out the majority of treatment: PST; communication with the oncology; translators during psychiatric evaluations; patient navigation/case management.. Note: patients choose first line therapy No role Monitoring antidepressants in consultation with psychiatrist in maintenance phase Supervise treatment, prescribe antidepressants. Weekly CDCS supervision CDCS interacts via written notes or verbally with the treating oncologist; CDCS and psychiatrist manage patients via a clinical data tracking secure website and weekly telephone supervision sessions Structured training in PST and the study algorithms Quality assurance by an independent ‘expert’ on 5 audiotaped SW sessions.
Fann [38] (2009) DCM (nurse or Clin psych) conduct psychosocial history, provide education and behavioral activation; identify treatment preferences: antidepressants and a structured six- to eight-session PST Make treatment choices No role Encouraged to see patients who presented diagnostic challenges/persistent depression for in-person consultations in the primary care setting. DCM met weekly with a supervising psychiatrist & primary care physician (PCP) to monitor clinical progress/adjust treatment plans Not reported Not reported
Kroenke [39] (2010) DPCM (nurse) recommends treatment in accordance with evidence-based guidelines; monitors response/adherence. Nil detects bothersome symptoms; implements treatment recommendation Supervises DPCM; advises on complex/nonresponding cases DPCM met weekly to review cases with the pain-psychiatrist to discuss management issues
Contact with oncology not specified
Not reported (though notes that the nurse was trained) Not reported
Sharpe [40] (2014) Nurse: psychoeducation &PST, behavioural activation; patient monitoring, communication, liaison patient, psychiatrist &GP Antidepressant Prescribing No specific role Supervise treatment; Review non-responders; prescribing advisory role. Weekly nurse supervision DCPC states:
Regular reports are sent to the GP (with copies to other relevant professionals) which detail the patient’s current antidepressant medication, depression score and progress in treatment. The reports are checked by a supervising psychiatrist before being sent and any recommendations are added regarding changes to antidepressant medication
2-3 month training. Achievement of competency in specific clinical areas (basic oncology, basic psychiatry, advanced communication skills, depression assessment and treatment, suicide risk assessment, problem solving therapy, use of the DCPC treatment manual).
Training comprised: tutorials, directed reading, role plays and simulated patient treatment sessions. Assessments were both written and practical
Treatment sessions video-recorded. Supervising psychiatrist watched the video-recordings of each nurse’s early sessions; detailed feedback.
Standardised rating sheets for each treatment session type completed by nurses and by the supervisors to determine adherence to the treatment approach. Specified behaviours and
proscribed behaviours assessed. An independent researcher rated 10% of DCPC sessions.
Walker [33] (2014) Nurse coordinates depression care by liaising with all relevant health professionals; symptom monitoring; Provide psychoeducation & PST Antidepressant Prescribing   Weekly review; Supervise treatment response; prescribing advisory role Regular reports are sent to the GP (with copies to other relevant professionals) which detail the patient’s current antidepressant medication, depression score and progress in treatment. The reports are checked by a supervising psychiatrist before being sent and any recommendations are added Achievement of competency, includes tutorials, directed reading, roleplay activities, stimulation patient sessions. Random sample of 10% video recordings of treatment sessions, rated for adherence to treatment manual + quality of delivery
Steel [34] (2016) Provision of CBT, telephone and face to face,recommendations for pharmacological management dependent on patient preferences, communication of patient preferences/change symptoms to medical team/primary physician Primary care could manage antidepressant prescribing Oncologist may manage antidepressant prescribing Weekly supervision between clinical psychologists and care coordinators - to assess adherence to protocol. The care coordinators provided information to the medical team about any changes in a patient’s symptoms that might have warranted changes in treatment, changing medication, or adding psychotherapy. However, the medical team may or may not have accepted the care coordinators’ recommendation 300-page intervention manual- included evaluation of depression and cognitive behavioural symptoms. Not reported