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  1. 28.7.2020

    Cancer patients are particularly vulnerable during the ongoing COVID-19 pandemic, often due to compromised immunity that can be caused by the cancer itself, or the resulting treatment. However, as the situation continues, thoughts turn from solely dealing with the physical effects of the pandemic to caring for the mental wellbeing of these patients, who are already dealing with anxiety-inducing circumstances.

    To this end, the FCT Research4Covid initiative recently chose to fund the creation of MoodUp: a digital platform to accelerate access to Mental Health care for cancer patients amid the pandemic: Champalimaud Research scientist Diana Frasquilho, who led the application, gives more information on this project.

    What was the idea behind this project?

    The COVID-19 pandemic is the biggest crisis of our recent history. Public health authorities have been warning about its effects on the population’s mental health as people cope with disrupted work, personal and social lives, family dynamics, finances and an uncertain future. The prevalence of clinically relevant anxiety and depression symptoms are likely to increase in the general population, but some groups are at higher risk. Vulnerable populations include individuals with pre-existing physical and/or mental health conditions.

    Cancer patients are at a higher risk of COVID-19 as their immune systems may be compromised. They also already have higher rates of depression and anxiety than the general population, which is understandable when dealing with severe illness. This issue might be exacerbated here in Portugal, where the overall rate for anxiety and mood disorders in the general population is very high (16% and 7,9% respectively*). Scaling-up mental health care capacity for our patients during the pandemic is thus needed to ensure their well-being.

    MoodUp will allow us to rapidly adopt eHealth tools and reorient the Oncology and Neuropsychiatry care teams in order to scale-up and accelerate mental healthcare capacity. In this way, we can improve the management of high-risk patients amid the COVID-19 pandemic (and future crises), while fostering links between care teams and, hopefully, creating a model that can be replicated by other institutions in the national health system.

    What impact could this project have?

    We expect the MoodUP eHealth platform to help tackle the under-detection of depression and anxiety and facilitate treatment, while improving patients’ health outcomes. We also aim to deliver a software platform that can be independently adapted or expanded to different care and research settings, thus facilitating know-how transfer amongst institutions in the national health system. Furthermore, we hope to optimise care at a distance, as well as reach a higher proportion of patients with other chronic illnesses. This will advance scientific and technological knowledge on collaborative mental healthcare in oncology, and distribute and/or expand the digital tool to improve overall mental health care management amid COVID-19 pandemic and for future crises.

    What is the process involved in achieving these goals, and what challenges will need to be overcome?

    Health services need to adapt quickly to the “new normal” and react to the challenges of this pandemic. In the MoodUP platform, patients will be 1) screened for anxiety and depressive symptoms; 2) triaged by the level of symptom severity and 3) be algorithm-matched to interventions based on their symptoms and their severity levels.

    The main challenge is the rapidly changing environment. Information technologies continue to be developed at high speed and scientific evidence about the pandemic is increasing. Therefore, the team will be highly engaged in a continual monitoring and involvement effort of the latest scientific and technological developments.

    Is there a key message to take away from this project?

    Better integration of mental healthcare into routine cancer care is crucial now, more than ever. This project builds on the multidisciplinary know-how of a team which includes medical doctors, psychologists, researchers in cancer and mental health, and patient managers. MoodUP will be an innovative solution to help tackle the mental health care gap in oncology amid the current global pandemic, and will allow for better preparation in the event of future crises.

    *Antunes A, Frasquilho D, Azeredo-Lopes S, Neto D, Silva M, Cardoso G, et al. Disability and common mental disorders: results from the World Mental Health Survey Initiative Portugal. European Psychiatry. 2018;49:56-61.doi: https://doi.org/10.1016/j.eurpsy.2017.12.004
    The creation and implementation of MoodUp involves the Champalimaud Clinical Centre in collaboration with Fernando Ferreira from the School of Science and Technology, NOVA University, Lisbon (FCT NOVA).


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