Evaluation of a repeated web-based screening procedure to detect anxiety and depression symptoms in Day Oncology patients ​

Abstract

Aim: Over 40% of cancer patients report clinical symptoms of anxiety or depression1. Early detection can facilitate timely intervention and improve patient outcomes. Current guidelines recommend regular screening using validated tools2, however barriers include time pressures, mental health stigma, and prioritisation of other health needs3. Routine web-based screening may offer a viable solution to increase detection of anxiety and depression. The aim of this study was to investigate the acceptability and clinical utility of repeated online psychological screening during cancer care.

Method: Forty-one patients were recruited from Austin Health Day Oncology Unit. Participants completed the Distress Thermometer (DT) and Problem Check-list, and the Hospital Anxiety and Depression Scale (HADS) on their personal electronic devices at 0, 8, and 16 weeks after their first chemotherapy session. Patients (n=33) and multidisciplinary staff (n=4) then provided feedback on the screening procedure via survey and/or interview.

Results: Approximately 1 in 2 patients reported clinically significant anxiety/depression symptoms at baseline. Over one-third of individuals who were below-threshold at baseline went on to report significant symptoms at week 8 and/or 16. DT scores were significantly positively correlated with HADS at all time points (p <.01). Almost all patients (>90%) reported that screening was easy, comfortable, and not burdensome. Patients also commented that regular screening motivated them to reflect on their wellbeing and seek support where needed. Staff-reported benefits included increased identification of patient distress, and assistance in making informed decisions about onward referrals. Reported challenges included confidence in technology and limited healthcare resources.

Conclusion: Repeated web-based anxiety and depression screening was found to be acceptable and useful by both patients and staff during cancer care.

Impact: This study highlights the importance of routine mental health screening throughout cancer care. It also shows that patients are happy to be asked directly and repeatedly about their emotional wellbeing.