Table 1 Descriptive summary of included studies

Barley et al., 2014 [78, 79]

United Kingdom

Pilot RCT (2 groups)

QAS:11

To explore the acceptability and feasibility of procedures to inform a definitive RCT of a practice nurse-led personalised care intervention for CHD patients with at least probable depression and chest pain.

Symptomatic chronic heart disease (with active chest pain)

N = 81 (T = 41, C = 40)

Mean age: 65 (SD = 11)

% female = 35.8

Race/ethnicity: 83% white

Mean HADS-D score: T = 12 (SD = 3), C = 11 (SD = 3)

T: Nine sessions (one face-to-face assessment + 15-min follow-up phone calls) with nurse focused on identifying problems contributing to depression, providing support resources, devising personal health plan, goal setting, and building self-efficacy.

C: Usual care.

Format: Individual.

Mode of delivery: Face-to-face and telephone.

Interventionist: Nurse.

Intervention duration: Mean 203 min (SD 100) of nurse time (mean 78min SD 19 for face-to-face assessment; mean 125min SD 91 in follow-up telephone calls).

Intervention length: 6-months.

Level of guidance: Guided

Timing of measures: 1-, 6-, and 12-months post baseline.

P: T1 = C for depression

T2 = C depression

S: T1 = C for anxiety

T1 = C for MCS and PCS

T2 = C for anxiety, MCS, and PCS

Boele et al., 2018 [80, 81]

Netherlands

RCT (3 groups)

QAS: 10

To decrease depressive symptoms using low-intensity guided self-help based on problem-solving therapy delivered online to increase accessibility and decrease barriers to accessing mental health care.

Glioma (CNS cancer)

N = 115 (T = 45, C1 = 26, C2 = 44)

Mean age: T = 43.6 (SD = 11.7), C1 = 52.8 (SD = 9.3), C2 = 46.4 (SD = 12.3)

% female: T = 57.8, C1 = 65.4, C2 = 59.1

Most common diagnosis in C1: non-Hodgkin lymphoma (46.2%)

Mean CES-D score: T = 21.5 (SD = 6.1), C1 = 25.1 (SD = 6.7), C2 = 24.1 (SD = 6.6)

T = Guided self-help course based on problem-solving therapy including disease specific information. Five modules and exercises. Online support and feedback on exercises provided by coach.

C1 = Non-CNS cancer control group. Received intervention.

C2 = Glioma 12-week waitlist control group (WLC).

Format: Individual.

Mode of delivery: Online

Interventionist: Psychologist, nurse, or psychology student (coaches).

Intervention duration: n/a

Intervention length: 5 weeks.

Level of guidance: Guided self-directed.

Timing of measures: 1.5-, 3-, 12-months post-baseline (last outcome measure not included for analysis as WLC group had completed intervention).

P: T1 = C2 for depression

S: T1 > C2 for MCS (ES: 0.87)

T1 = C2 for PCS

Espahbodi et al., 2015 [82]

Iran

Quasi-experimental (randomized matched design)

QAS: 6

To investigate the impacts of education on psychological symptoms (anxiety and depression) in patients undergoing dialysis.

Renal Failure (receiving dialysis)

N = 55 (T = 27, C = 28)

Mean age: T = 49.1 (SD = 14.5), C = 52.3 (SD = 15.6)

% female: T = 52, C = 50

Mean HADS-D: T = 10.2 (SD = 3.4), C = 10.1 (SD = 3.4)

T: Psychoeducational intervention (3 sessions × 60 min) focused on disease-specific information (e.g., physiology, causes, treatments) as well as problem-solving, stress management, adaptive responses, and muscle relaxation.

C: Usual care.

Format: Group

Mode of delivery: Face-to-face.

Interventionist: Unspecified. In collaboration with a nephrologist and psychiatrist.

Intervention duration: 180 min.

Intervention length: Approximately 5 days.

Level of guidance: Guided.

Timing of measures: 1-month post-baseline.

P: T1 = C for depression and anxiety

Fischer et al., 2015 [83]

Germany

RCT (2 groups)

QAS: 9

To evaluate the feasibility and efficacy of a fully automated internet-based CBT program to reduce depressive symptoms in patients with multiple sclerosis (MS).

Multiple sclerosis

N = 90 (T = 45, C = 45)

Mean age: T = 45.4 (SD = 12.6), C = 4524 (SD = 10.6)

% female: T = 76, C = 80

Mean BDI score: T = 19.4 (SD = 9.0), C = 18.4 (SD = 8.2)

T = Ten online modules using simulated dialogue and tailored based on participant response. Content draws on: 1) behavioral activation, 2) cognitive modification, 3) mindfulness and acceptance, 4) interpersonal skills, 5) relaxation, physical exercise and lifestyle modification, 6) problem solving, 7) childhood experiences and early schemas, 8) positive psychology interventions, 9) dreamwork and emotion-focused interventions, and 10) psychoeducation.

C = 2.25-month WLC

Format: Individual.

Mode of delivery: Online.

Interventionist: Self-directed.

Intervention duration: Self-directed. Mean use: 332 min (range 50–905 min).

Length of intervention: 2.25 months.

Level of guidance: Self-directed.

Timing of measures: 2.25- and 8.25-months post-baseline (last outcome measure not included for analysis as WLC group had completed intervention).

P: T1 = C for depression

S: T = C for fatigue

Lamers et al., 2010a [84, 85]

Netherlands

RCT (2 groups)

QAS: 12

To evaluate the effectiveness of a nurse-administered minimal psychological intervention in reducing depressive symptoms in elderly primary care patients with type II diabetes or COPD with co-morbid non-severe depression and examine whether type of chronic illness modified the effects of the intervention.

Type II diabetes, COPD

N = 361 (T = 183, C = 178)

Mean age: T = 70.8 (SD = 6.5), C = 70.6 (SD = 6.8)

% female: T = 46.4, C = 46.6

Primary diagnosis:

T: 49.7% diabetes, 50.3% COPD

C: 52.8% diabetes, 47.2% COPD

Mean BDI score:

T = 17.1 (SD = 7.2)

C = 17.7 (SD = 8.0)

T = Tailored intervention with variable number of sessions (2–10) based on principles of self-management and CBT and includes 5 phases: 1) exploring feelings, cognitions, and behaviours, 2) mood, symptom, and behaviourmonitoring, 3) linking mood to behaviour, 4) action planning, and 5) evaluation of progress in achieving goals. 

C = Usual care.

Format: Individual.

Mode of delivery: Face-to-face.

Interventionist: Nurse.

Intervention duration: Mean 240 min.

Intervention length: Tailored up to 3-months.

Level of guidance: Guided.

Timing of measures: Approximately 3.25-, 6-, and 12-months post-baseline (assuming 3-month intervention period).

P: T1 = C for depression

T2 = C for depression

S: T1 = C for MCS and PCS

T2 = C for MCS and PCS

COPD sub-group*

T1 = C for MCS

T2 = C for MCS

DMII sub-group*

T1 = C for MCS

T2 = C for MCS (note: T>C for MCS at 9-months post intervention completion)*

Lamers et al. 2010b [86]

Note: Subgroup analysis of Lamers 2010a

Netherlands

RCT (2 groups)

To evaluate the effect of a nurse-administered minimal psychological intervention on disease specific quality of life, depression, and anxiety in elderly primary care patients with COPD with co-morbid non-severe depression.

COPD

N = 187 (T = 96, C = 91)

Mean age: T = 70.5 (SD = 6.3), C = 71.5 (SD = 7.1)

% female: T = 38.5, C = 41.8

Mean BDI score:

T = 17.1 (SD = 6.5), C = 18.3 (SD = 7.2)

See Lamers et al., 2010a

P: T1 = C for depression*

T2 = C for depression* (Note: T>C for depression at 9-months post intervention completion).* S: T1=C for anxiety* T2=C for anxiety* (Note: T>C for anxiety at 9-months post intervention completion)*

Lamers et al., 2011 [87]

Note: Subgroup analysis of Lamers 2010a

Netherlands

RCT (2 groups)

To evaluate whether a nurse-administered minimal psychological intervention based on CBT and self-management principles improves disease-specific quality of life and glycemic control in patients with type II diabetes and co-morbid non-severe depression.

Type II diabetes

N = 208 (T = 105, C = 103)

Mean age: T = 70.7 (SD = 6.6), C = 69.7 (SD = 6.6)

% female: T = 51.4, C = 50.4

Depression level: Not specified. Participants underwent Mini International Neuropsychiatric review. Those with minor depression, mild-to-moderate major depression or dysthymia were included.

See Lamers et al., 2010a

S: T1 = C for glycemic control (HbA1c)

T2 = C for glycemic control (HbA1c)

Lee et al., 2014 [88]

Republic of Korea

Quasi-RCT – group allocation based on consent date (2 groups)

QAS: 12

To evaluate the effectiveness of a tablet PC-based single session psychoeducation intervention for cancer patients reporting significant levels of distress.

Type II diabetes

*per group data not available

N = 36 (T = 19, C = 17)

Median age: 57.5 (range 34–71)

% female: 55.6

Mean HADS-D score:

T = 12.0 (SD = 3.7), C = 12.7 (SD = 1.5)

T = Twenty-minute psychoeducation video clip. Content consisted of distress education, cancer survivor interview, coping strategies and stress management, and psychological services.

C = Control movie clip of scenic images and relaxing music.

Format: Individual.

Mode of delivery: Video presented on computer tablet.

Interventionist: n/a

Intervention duration: 20-min.

Length of intervention: 20-min.

Level of guidance: Self-directed

Timing of measures: 1-day (post-intervention same day as baseline measures) and 2–4 weeks post-baseline.

P: T1 > C for depression (ES: − 1.13) and MCS (ES: 1.08)

T1 = C for anxiety

Moncrieft et al., 2016 [89]

United States

RCT (2 groups)

QAS: 9

To determine the effect of a multicomponent behavourial intervention on weight, glycemic control, renal function, and depressive symptoms in adults with DMII and depressive symptoms.

Cancer patients receiving chemotherapy treatment

N = 111 (T = 57, C = 54)

Mean age: T = 54.8 (SD = 8.3), C = 54.8 (SD = 6.3)

% female: T = 64.9, C = 77.8

Mean BDI-II score: T = 19.3 (SD = 7.1)

C = 21.2 (SD = 7.1)

T: Structured lifestyle intervention (17 sessions × 1.5–2 h). Two individual sessions followed by two weekly, four bi-weekly, and nine monthly group sessions. Intervention components focused on diet and physical activity, including a weight loss, exercise, and caloric intake goals, combined with cognitive behavioural and social learning approaches to managing depression.

C: Usual care + brief educational booklet on diabetes management.

Format: Individual and group.

Mode of delivery: Face-to-face.

Interventionist: Therapists.

Intervention duration: 1530 to 2040 min.

Intervention length: 12-months.

Level of guidance: Guided.

Timing of measures: 6- and 12-months post-baseline.

P: T2 > C for depression (ES: − 0.62)

T2 = C for glycemic control (HbA1c)

Penckofer et al., 2012 [90]

United States

RCT (2 groups)

QAS: 12

To examine the effects of a nurse-delivered psychoeducation intervention on depression, anxiety, and anger among women with type II diabetes.

Type II diabetes

N = 74 (T = 38, C = 36)

Mean age: T = 54.8 (SD = 8.8), C = 54.0 (SD = 8.4)

% female: 100

Mean CES-D score: T = 27.7 (SD = 9.3)

C = 28.9 (SD = 9.5)

T = Sessions [(8 weekly sessions + 2 booster sessions) ×  1 h/session] focused on recognizing signs and symptoms of depression, relationship between mood, metabolic control, and self-care behaviours, the management of depression, anxiety, and anger using CBT. Includes elements from existing interventions such as CBT program for depression, progressive muscle relaxation CD, and system for management of anger including workbook and video.

C = Usual care.

Format: Group.

Mode of delivery: Face-to-face.

Interventionist: Nurse.

Intervention duration: 600 min

Intervention length: 6-months

Level of guidance: Guided.

Timing of measures: 3- and 6-months post-baseline.

P: T1 > C for depression (ES: − 0.78)

T1 = C for trait anxiety

T1 = C for state anxiety

T2 > C for depression (ES: − 0.94) and trait anxiety (ES: − 0.62)

T2 = C for state anxiety (ES: − 0.74)

S: T1 = C for MCS,

PCS, and

glycemic control (HbA1c)

T2 = C for PCS and glycemic control (HbA1c)

T2 > C for MCS (ES: 0.60)

Rees et al., 2017 [91]

Australia

Pilot RCT (2 groups)

QAS: 13

To provide preliminary evidence for the impact of problem-solving therapy for diabetes in adults with diabetic retinopathy and diabetes distress.

Type II diabetes and diabetic retinopathy

N = 40 (T = 21, C = 19)

Mean age: T = 60.1 (SD = 7.0), C = 59.6 (SD = 8.8)

% female: T = 33.3, C = 31.6

Mean PHQ-9 score: T = 10.5 (SD = 5.2)

C = 10.2 (SD = 5.7)

T: Provided publicly available information on diabetes + problem solving therapy for diabetes, which consisted of weekly sessions (8 × 45–60 min) in which participants identified problems related to diabetes and were guided through a problem-solving process. Participants were also asked to make plans to engage in enjoyable activities.

C: Usual care + same publicly available brochures on diabetes as T group.

Format: Individual

Mode of delivery: Phone or in-person (based on preference and availability).

Interventionist: Research assistant supervised by clinical psychologist.

Intervention duration: 360–480 min.

Intervention length: 2-months

Level of guidance: Guided.

Timing of measures: 3- and 6-months post-baseline.

S: T1 = C for depression and glycemic control (HbA1c)

T2 = C for depression and glycemic control (HbA1c)

Schroder et al., 2014 [92]

Germany

RCT (2 groups)

QAS: 10

To evaluate the feasibility and efficacy of an online program for depression in individuals with epilepsy and co-morbid depressive symptoms.

Epilepsy

N = 78 (T = 38, C = 40)

Mean age: T = 35.0 (SD = 10.0), C = 40.0 (SD = 11.9)

% female: T=67.5, C=84.2

Mean BDI score:

T = 22.2 (SD = 10.4)

C = 19.4 (SD = 9.8)

T: Ten online modules (10–60 min each) comprised mostly of CBT elements (cognitive restructuring, behavioural activation) and mindfulness and acceptance exercises.

C: 9-week WLC

Format: Individual

Mode of delivery: Online.

Interventionist: Self-directed.

Intervention duration: 100–600 min.

Intervention length: 2.25 months.

Level of guidance: Self-directed.

Timing of measures: 2.25 months post-baseline.

P: T1 = C for depression

Sharpe et al., 2004 [93]

United Kingdom (Scotland)

Non-randomized matched control group design (2 groups)

QAS: 12

To perform preliminary evaluation of the feasibility and efficacy of a nurse-led intervention with oncology outpatients.

Cancer (outpatients with breast, gynaecological, bladder, prostate, testicular and colorectal)

N = 60 (T = 30, C = 30)

Mean age: T = 58.0 (SD = 10.6), C = 56.0 (SD = 10.5)

% female: T = 93.3, C = 93.3

Mean HADS-D score:

T = 10.4 (SD = 3.6)

C = 10.3 (SD = 4.0)

T: The intervention consisted of up to 10 weekly problem-solving therapy sessions (30 min each) to help with a positive and systematic approach to tackling problems, education about depression, encouragement to speak with their general practitioner about anti-depressant medication, and coordination and monitoring of the participant’s depression treatment. Participants could contact the nurse for further booster sessions.

C: Usual care.

Format: Individual.

Mode of delivery: Face-to-face or phone.

Interventionist: Nurse supervised by psychiatrist.

Intervention duration: Nurse spent mean of 360 min with participants.

Intervention length: Ranged from 0.5–4 months (with 6 participants requesting booster sessions).

Level of guidance: Guided.

Timing of measures: 3- and 6-months post-baseline.

P: T1 > C for depression (ES: − 0.87)

T2 > C for depression (ES: − 0.58)

S: T1 > C for anxiety (ES: − 1.25)

T2 > C for anxiety (ES: − 0.88)

Sharpe et al., 2014 [94]

(SMaRT Oncology-2)

United Kingdom (Scotland)

RCT (2 groups)

QAS: 14

To compare the effectiveness of an integrated treatment programme for major depression in patients with cancer with usual care for patients with cancer who have co-morbid major depression and a survival prognosis of at least a year.

Cancer with prognosis of survival over 12-months.

N = 500 (T = 253, C = 247)

Mean age: T = 56.6 (SD = 10.0), C = 56.1 (SD = 10.2)

% female: T = 90, C = 90

Mean SLC-20 score:

T = 2.10 (SD = 0.62)

C = 2.11 (SD = 0.56)

T: Based on Strong et al. (2008). Primary care physician and oncologist informed of major depression disorder diagnosis + multicomponent treatment program integrated into cancer care in which participants form relationships with nurses who provide information about depression, deliver problem-solving therapy, and monitor progress (up to 10 sessions X 45 min and additional sessions available for those not meeting treatment targets).

C: Usual care + primary care physician and oncologist informed of major depression diagnosis + participant encouraged to consult their primary care physician to obtain treatment.

Format: Individual.

Mode of delivery: Primarily face-to-face, sometimes telephone.

Interventionist: Oncology nurses supervised by a psychiatrist.

Intervention duration: 405 min. Median number of sessions: 9 (range 0–10).

Intervention length: 4-months for initial sessions and further sessions for those who are not meeting treatment targets.

Level of guidance: Guided.

Timing of measures: 3-, 6-, 9-, and 12-months post-baseline.

P: T1 > C for depression (ES: − 0.87)

T2 > C for depression (ES: − 1.03)

S: T1 > C for anxiety (ES: − 0.61) and fatigue (ES: − 0.41)

T2 > C for anxiety (ES: − 0.71) and fatigue (ES: − 0.60)

Strong et al., 2008 [95]

(SMaRT oncology 1)

United Kingdom (Scotland)

RCT (2 groups)

QAS: 14

To assess the efficacy and cost of a nurse-delivered complex intervention designed to treat major depressive disorder in patients with cancer.

Cancer

N = 200 (T = 101, C = 99)

Mean age: T = 56.6 (SD = 11.4), C = 56.6 (SD = 12.3)

% female: T = 69, C = 72

Median SCL-20 score (IQR): T = 2.35 (2.05–2.75), C = 2.25 (1.95–2.75)

T: Maximum of 10 session (45-min each) over 3-months followed by monthly monitoring of symptoms in the next 3-months and. optional 1–2 sessions for those whose depression scores increased. The intervention included education about depression and treatment, problem-solving treatment, and communicating with the participant’s primary care physician and oncologist about their depression diagnosis.

C: Usual care + informed primary care physician and oncologist of depression diagnosis and, if requested, provided advice regarding choice of antidepressant medication.

Format: Individual.

Mode of delivery: Primarily in-person, some by telephone if needed.

Interventionist: Oncology nurse supervised by a psychiatrist.

Intervention duration: Mean of 315 min based on mean of 7 sessions (range 2–10).

Intervention length: 6-months.

Level of guidance: Guided.

Timing of measures: 3-, 6-, and 12-months post-baseline

P: T1 > C for depression*

T2 > C for depression*

S: T1 > C for anxiety and fatigue*

T2 > C for anxiety and fatigue*

Thorton et al., 2009 [96]

United States

RCT (2 groups)

Secondary analysis

QAS: 11

To test experimentally whether a psychological intervention reduces depression-related symptoms and markers of inflammation among cancer patients.

Breast cancer (Stage II/III, surgically treated, and waiting for adjuvant therapies)

N = 45 (T = 23, C = 22)

Mean age: T = 50.0 (SD = 8.6), C = 50.0 (SD = 11.6)

% female: 100

Mean CES-D Iowa short-form score not reported. All participants included in the secondary analysis scored ≥10 as part of inclusion criteria.

T: Group sessions of 8–12 patients for 90 min for 18 weekly sessions followed by 8 monthly sessions. Topics included stress management, emotional distress, social adjustment, health behaviours (e.g., diet, exercise), and adherence to treatment.

C: Usual care.

Format: Group.

Mode of delivery: Face-to-face (some telephone contact to catch up on information if sessions were missed).

Interventionist: Psychologists.

Intervention duration: 2340 min.

Intervention length: 12-months.

Level of guidance: Guided.

Timing of measures: 4-, 8-, 12-months post-baseline.

P: T1 > C for depression*

T2 > C for depression*

S: T1 > C for fatigue*

T2 > C for fatigue*

Walker et al., 2014 [97]

(SMaRT Oncology-3)

United Kingdom (Scotland)

RCT (2 groups)

QAS: 13

To assess the efficacy of an integrated treatment program for major depressive disorder in patients with lung cancer compared with usual care.

Lung cancer

N = 142 (T = 68, C = 74)

Mean age: T = 63.6 (SD = 8.8), C = 63.9 (SD = 8.7)

% female: T = 65, C = 65

Mean SCL-20 score: T = 1.90 (SD 0.52), C = 1.98 (0.58)

T: Adapted from Sharpe et al. (2014). Maximum of 10 sessions (30–45 min) over 4-months followed by monitoring of symptoms and optional additional sessions for participants who did not meet treatment target. Nurses establish therapeutic relationship, provide information about depression, delivey problem-solving therapy and behavioural activation and monitor progress. Psychiatrists supervise treatment, advise primary care physicians, and provide direct consultation to participants not progressing.

C: Usual care + primary care physician and oncologist informed of the diagnosis of major depression and participant encouraged to see primary care physician to obtain treatment.

Format: Individual.

Mode of delivery: Primarily face-to-face, some telephone contact.

Interventionist: Nurse and psychiatrist.

Intervention duration: 240–360 min (median number of sessions 8 IQR 7–10).

Intervention length: 8-months.

Level of guidance: Guided.

Timing of measures: 1-, 2-, 3-, 4-, 5-, 6-, 7-, and 8-months post-baseline. Outcomes averaged over the participants time in the trial (up to 8-months).

Outcomes averaged over the participants time in the trial (up to 8-months).

P: T > C for depression*

S: T > C for anxiety*

T = C for fatigue*