Anxiety and depression are common in cancer patients, occurring in about 20% of those affected. Despite good evidence for effective interventions, these mental disorders are still frequently missed, and not effectively treated. Clinical pathways have shown considerable success in bringing about change in patient management, however the context and implementation strategies utilised are critical. The Clinical Pathway for the Identification and Management of Anxiety and Depression in Adult Cancer Patients advocates routine screening across the cancer journey, promoting early identification and prompt access to evidence-based care as well as educational support of cancer care staff to guide appropriate and successful implementation. Our barrier analysis identified lack of resources, education and training and support from leaders; poor uptake by patients; and lack of integration within the community, as key factors that would influence uptake of the Clinical Pathway in routine practice. Our Anxiety and Depression Pathway (ADAPT) research program has developed a suite of resources addressing these barriers and facilitators.

These include: (i) the ADAPT Portal, a flexible web-based system to operationalise the Clinical Pathway tailored for individual cancer services, (ii) an online health professional training program focusing on skills related to screening and discussion about referral with patients; (iii) a purpose-built online CBT-based therapy program for managing anxiety/depression in the cancer context, iCanADAPT; and (iv) patient resources to inform, normalise and de-stigmatise routine screening and managing the impact of cancer on emotional wellbeing.

Lessons learned from pilot testing these resources will be discussed, as well as our cluster RCT of two implementation strategies in 12 cancer services in NSW.

Professor Phyllis Butow (BA(Hons), MPH, MClinPsych, PhD) is Professor, and NHMRC Senior Principal Research Fellow in the School of Psychology at the University of Sydney. She founded the Australian Psycho-Oncology Co-operative Research Group (PoCoG) and the Centre for Medical Psychology and Evidence-based Decision-making (CeMPED). Professor Butow has worked for over 20 years in the areas of doctor-patient communication and Psycho-Oncology. She has won many awards, including the International Psycho-Oncology Society Bernard Fox award for outstanding contribution to Psycho-Oncology research in 2009 and the Clinical Oncological Society of Australia Tom Reeve award for outstanding contribution to cancer care in 2011, and was named NSW Cancer Researcher of the year in 2012. She received an Order of Australia for her work in 2014. Professor Butow has conducted a large body of research on patient and family support, patient involvement in cancer consultations and decision-making, psychosocial issues in cancer genetics, and disparities in outcomes and needs of immigrants with cancer.