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

Joanne Shaw*, Suvena Sethi, Lisa Vaccaro, Lisa Beatty, Laura Kirsten, David Kissane, Brian Kelly, Geoff Mitchell, Kerry Sherman, Jane Turner

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    21 Citations (Scopus)
    53 Downloads (Pure)


    Background: Collaborative care involves active engagement of primary care and hospital physicians in shared care of patients beyond usual discharge summaries. This enhances community-based care and reduces dependence on specialists and hospitals. The model, successfully implemented in chronic care management, may have utility for treatment of depression in cancer. The aim of this systematic review was to identify components, delivery and roles and responsibilities within collaborative interventions for depression in the context of cancer. 

    Methods: Medline, PsycINFO, CINAHL, Embase, Cochrane Library and Central Register for Controlled Trials databases were searched to identify studies of randomised controlled trials comparing a treatment intervention that met the definition of collaborative model of depression care with usual care or other control condition. Studies of adult cancer patients with major depression or a non-bipolar depressive disorder published in English between 2005 and January 2018 were included. Cochrane checklist for risk of bias was completed (Study Prospero registration: CRD42018086515). 

    Results: Of 8 studies identified, none adhered to the definition of 'collaborative care'. Interventions delivered were multi-disciplinary, with care co-ordinated by nurses (n = 5) or social workers (n = 2) under the direction of psychiatrists (n = 7). Care was primarily delivered in cancer centres (n = 5). Care co-ordinators advised primary care physicians (GPs) of medication changes (n = 3) but few studies (n = 2) actively involved GPs in medication prescribing and management.

    Conclusions: This review highlighted joint participation of GPs and specialist care physicians in collaborative care depression management is promoted but not achieved in cancer care. Current models reflect hospital-based multi-disciplinary models of care.

    Original languageEnglish
    Article number120
    Pages (from-to)1-18
    Number of pages18
    JournalBMC Health Services Research
    Issue number1
    Publication statusPublished - 14 Feb 2019

    Bibliographical note

    Copyright the Author(s) 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


    • collaborative care
    • shared care
    • systematic review
    • depression
    • cancer
    • randomised controlled trial


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