TY - JOUR
T1 - A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices
T2 - the UPBEAT-UK RCT protocol and recruitment
AU - Tylee, André
AU - Haddad, Mark
AU - Barley, Elizabeth
AU - Ashworth, Mark
AU - Brown, June
AU - Chambers, John
AU - Farmer, Anne
AU - Fortune, Zoe
AU - Lawton, Rebecca
AU - Leese, Morven
AU - Mann, Anthony
AU - McCrone, Paul
AU - Murray, Joanna
AU - Pariante, Carmine
AU - Phillips, Rachel
AU - Rose, Diana
AU - Rowlands, Gill
AU - Sabes-Figuera, Ramon
AU - Smith, Alison
AU - Walters, Paul
N1 - Funding Information:
This protocol presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RPPG-0606-1048). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. We would like to thank Andrew Steptoe, Roger Jones, Peter Bower, and Christopher Dickens who provided independent advice and in the development of the UPBEAT-UK Programme as a whole and this pilot RCT in particular. Andre Tylee is partly funded by the NIHR Mental Health Biomedical Research Centre at the South London and Maudsley Foundation Mental Health Trust and the Institute of Psychiatry at King’s College London. We would also like to thanks colleagues at the Mental Health and Neuroscience Clinical Trials Unit at the Institute of Psychiatry, King’s college London for the expert management of randomisation and data capture.
PY - 2012/6/6
Y1 - 2012/6/6
N2 - Background: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings.Methods: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care.81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ≥8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant's physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant's mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient's self efficacy to solve their problems. Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation.Discussion: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care.Trial registration: ISRCTN21615909.
AB - Background: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings.Methods: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care.81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ≥8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant's physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant's mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient's self efficacy to solve their problems. Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation.Discussion: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care.Trial registration: ISRCTN21615909.
UR - http://www.scopus.com/inward/record.url?scp=84861802070&partnerID=8YFLogxK
U2 - 10.1186/1471-244X-12-58
DO - 10.1186/1471-244X-12-58
M3 - Article
C2 - 22672407
AN - SCOPUS:84861802070
SN - 1471-244X
VL - 12
JO - BMC Psychiatry
JF - BMC Psychiatry
M1 - 58
ER -