Online Program for Depression in Cancer Patients

(iPath Pilot Trial)

Overseen By Paul Barr, Ph.D.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Dartmouth-Hitchcock Medical Center

Disqualifiers: Suicidal ideation, Bipolar, Psychosis, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

30 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to determine the extent to which an online pathway to depression treatment (iPath\*D) is acceptable and usable to patients receiving cancer treatment who report symptoms of depression.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, if you are currently receiving treatment for a mental health condition, you may not be eligible to participate.

What data supports the effectiveness of the treatment iPath*D for depression in cancer patients?

Research shows that both antidepressants and psychotherapy are effective in treating depression in cancer patients, similar to their effectiveness in other medical conditions. This suggests that treatments like iPath*D, which may include these components, could be beneficial for depression in cancer patients. ^{1 2 3 4 5}

How is the treatment iPath*D different from other treatments for depression in cancer patients?

iPath*D is unique because it is an online program specifically designed to help cancer patients manage depression, offering a convenient and accessible alternative to traditional face-to-face therapy, which can be difficult for patients to attend due to their medical condition. ^{2 3 4 6 7}

Research Team

Paul Barr, Ph.D.

Principal Investigator

Dartmouth College

Eligibility Criteria

This trial is for adults over 18 who are starting treatment at NCCC North and returning for chemo teach or radiation simulation. They must be able to communicate in English and have mild to moderately severe depression, as indicated by a score of 10-27 on the PHQ-9 depression scale.

Inclusion Criteria

PHQ-9 score between ≥10 and ≤27

Can communicate in English

I am a new patient at Dartmouth Cancer Center North, here for my chemo teach or radiation simulation.

Exclusion Criteria

Mild Depression (PHQ-9 score ≥10)

Individuals who screen positive for suicidal ideation with method, intent, plan or a recent prior suicide/self-harm attempt, as determined by a positive endorsement of items 3, 4, 5 or 6 on the Columbia-Suicide Severity Rating Scale (C-SSR)

Individuals with bipolar disorder or psychosis (documented in the EMR)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

Online screening

Treatment

Participants use the iPath*D online platform to access depression treatment options

6 weeks

Online access to treatment options

Follow-up

Participants are monitored for changes in mental health literacy, quality of life, and treatment adherence

6 weeks

Online follow-up assessments

Treatment Details

Interventions

• iPath*D

Trial Overview The study is testing iPath*D, an online pathway designed to help cancer patients with symptoms of depression access treatment. The goal is to see if this digital tool is both acceptable and user-friendly for those undergoing cancer therapy.

Participant Groups

Group I: iPath*D Experimental Treatment 1 Intervention

An online platform that connects patients screening positive for clinically significant depression in cancer settings to a range of online and inperson evidence-based treatments, facilitated by an interactive DA.

Who Is Running the Clinical Trial?

Dartmouth-Hitchcock Medical Center

Lead Sponsor

Trials

548

Recruited

2,545,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Findings from Research

The COPE-D intervention significantly improved depression and quality of life for underserved cancer patients, with 65% of participants showing treatment improvement and 56% achieving a significant treatment response.

Outcomes such as suicidal ideation, anxiety, sleep disturbance, and social isolation also improved, indicating the intervention's broad effectiveness across various mental health aspects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaborative depression care sensitive to the needs of underserved patients with cancer: Feasibility, acceptability and outcomes. Price, S., Hamann, HA., Halaby, L., et al.[2023]

A study involving 27 participants with advanced cancer showed that a six-lesson internet-delivered cognitive behavioral therapy (iCBT) was feasible and acceptable, with high treatment satisfaction reported by most participants.

Participants who completed the iCBT experienced significant reductions in anxiety and depression symptoms, suggesting that this online therapy could be an effective support for individuals facing mental health challenges due to advanced cancer.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A mixed methods pilot and feasibility open trial of internet-delivered cognitive behaviour therapy (iCanADAPT Advanced) for people with advanced cancer with depression and/or anxiety. Murphy, MJ., Newby, JM., Butow, P., et al.[2023]

The study will evaluate the effectiveness of the online self-help program epos in reducing anxiety and depression symptoms among 325 German-speaking cancer patients transitioning from inpatient to outpatient care.

If successful, epos could provide a valuable, accessible adjunct to traditional face-to-face psycho-oncological support, particularly for patients facing barriers to in-person interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial. Tsiouris, A., Mayer, A., Nölke, C., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Collaborative depression care sensitive to the needs of underserved patients with cancer: Feasibility, acceptability and outcomes. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Treatment of depression in cancer. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Correlates of oncologist-issued referrals for psycho-oncology services: what we learned from the electronic voluntary screening and referral system for depression (eVSRS-D). [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Putting evidence into practice: interventions for depression. [2018]

5. England pubmed.ncbi.nlm.nih.gov

Patient-reported depression measures in cancer: a meta-review. [2022]

6. Netherlands pubmed.ncbi.nlm.nih.gov

A mixed methods pilot and feasibility open trial of internet-delivered cognitive behaviour therapy (iCanADAPT Advanced) for people with advanced cancer with depression and/or anxiety. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial. [2022]