Expert opinion on detecting and treating depression in palliative care: A Delphi study

BMC Palliative Care

Research Article

Irene J Higginson¹  Lauren Rayner²  Annabel Price³  Matthew Hotopf³ 

[1] Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College, London, UK;Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College, London, UK;Department of Psychological Medicine, The Institute of Psychiatry, King's College, London, UK;Department of Psychological Medicine, The Institute of Psychiatry, King's College, London, UK;

关键词: Palliative Care;    Mirtazapine;    Escitalopram;    Expert Group;    Mianserin;   

DOI  :  10.1186/1472-684X-10-10

 received in 2010-12-15, accepted in 2011-05-27,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThere is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of best practice recommendations for the European Palliative Care Research Collaborative clinical practice guideline on managing depression in palliative care.Methods18 members of an international, multi-professional expert group completed a structured questionnaire in two rounds, rating their agreement with proposed items on a scale from 0-10 and annotating with additional comments. The median and range were calculated to give a statistical average of the experts' ratings.ResultsThere was contention regarding the benefits of screening, with 'routine informal asking' (median 8.5 (0-10)) rated more highly than formal screening tools such as the Hospital Anxiety and Depression Scale (median 7.0 (1-10). Mirtazapine (median 9 (7-10) and citalopram (median 9 (5-10) were the considered the best choice of antidepressant and cognitive behavioural therapy (median 9.0 (3-10) the best choice of psychological therapy.ConclusionsThe range of expert ratings was broad, indicating discordance in the views of experts. Direct comparative data from randomised controlled trials are needed to strengthen the evidence-base and achieve clarity on how best to detect and treat depression in this setting.

【 授权许可】

CC BY   
© Rayner et al; licensee BioMed Central Ltd. 2011