The Clinical and Cost Effectiveness of CBT Plus Treatment as Usual for the Treatment of Depression in Advanced Cancer: A Randomised Controlled Trial (The CanTalk Study); The Feasibility Phase

Depression is a prevalent mental disorder in patients with cancer. Cognitive Behavioural Therapy (CBT) has been shown to treat effectively major depression; however there is little empirical evidence of its efficacy for patients with advanced cancer. Aim: This study (CanTalk, funded by UK National Institute of Health Research Health Technology Assessment programme) investigates whether CBT, accessed through the UK NHS Improved Access to Psychological Therapies Service, is an effective treatment for depression in those with advanced cancer. Study design: CanTalk is a single-blinded randomised controlled trial (RCT), recruiting from several primary and secondary NHS sites across the UK. Adults with Advanced Cancer (prognosis greater than four months) and depression were randomised to treatment as usual or CBT plus treatment as usual. The treatment phase lasts for up to 12 weeks, with depression, quality of life and economic measures at six-weekly intervals up until 24 weeks postrandomisation. Results: The feasibility phase measures recruitment and retention rates in a small number of sites so that procedures can be adjusted if rates are not as estimated. Low eligibility rates for the trial and increased risk of attrition because of ill health require a larger population size from which to recruit; this has implications for trial coordination and set up. Gaining NHS permissions in multiple Trusts and support in General Practices is a lengthy process and the reorganisation of NHS services further complicates trial set up. Conclusion: Recruitment commenced in September 2012. We shall present recruitment, retention, follow-up and attrition data from the feasibility phase. We shall report whether strategies to address the recruitment and retention challenges were successful