Can E-therapies Reduce Waiting Lists in Secondary Mental Health Care? A Randomized Controlled Trial
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|ClinicalTrials.gov Identifier: NCT02423733|
Recruitment Status : Active, not recruiting
First Posted : April 22, 2015
Last Update Posted : December 18, 2018
Depression is common and disabling but access to specialist treatment is often delayed with waiting lists of up to a year not uncommon. Also treatment is frequently limited to drug therapies because of long waiting lists to see psychological therapists face to face despite recommendations by NICE (The National Institute for Health and Clinical Excellence) and others about the importance of non-drug therapies. One way to address this problem is to use computerized e-therapies which deliver structured cognitive behavioral treatment where the therapy can be accessed in a location and at a time that is convenient for patients and where there is no waiting list. Previous randomized controlled trials of e-therapies for depression have mainly been in people recruited through the internet or in clinical populations with mild disorders where many participants do not complete the on-line course. Despite this there is some evidence that clinician-assisted computerized cognitive behavior therapy can result in significant improvements in depression with reduced demands on clinician time. To date there have been no trials of clinician assisted e-therapy in secondary care.
Therefore the aim of this clinical trial is to answer the question "In patients on the waiting list for the mood program does a computerized therapy with an e-therapy coach compared to written information about depression and the availability of computerized treatments result in better outcomes, quicker improvements and the use of fewer resources after 12 weeks". The study will be a randomized controlled trial with health service use and PHQ-9 as the main outcome measures.
|Condition or disease||Intervention/treatment||Phase|
|Depression||Other: The Journal||Not Applicable|
Show Detailed Description
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||110 participants|
|Intervention Model:||Parallel Assignment|
|Official Title:||Can E-therapies Reduce Waiting Lists in Secondary Mental Health Care? A Randomized Controlled Trial|
|Actual Study Start Date :||April 2015|
|Actual Primary Completion Date :||July 2016|
|Estimated Study Completion Date :||May 31, 2019|
No Intervention: Control
In addition to their usual clinical care will also be given written information about web sites that provide information on depression but will not be specifically directed to The Journal.
Experimental: Computerized Therapy
In addition to their usual clinical care they will receive an invitation to use The Journal supported by an e-therapy coach who will provide patients with weekly email or telephone contact. The e-therapy coach will have a guideline script for each lesson of The Journal to reinforce the topic of each lesson, help identify and support patients in their goals and to coach them in goal setting and the techniques of problem solving.
Other: The Journal
"The Journal" is a free internet based program for the self-management of depression (www.depression.org.nz) that was developed in New Zealand and capitalizes on the social marketing appeal of Sir John Kirwan, an ex All Black who has described his experiences of depression to help destigmatize mental illness. . The self-help program is based on the cognitive behavioral techniques of behavioral activation and problem solving which teaches patients the skills of problem solving and delivers an evidence based intervention which is personalized for their individual care.
- Change in Scores on PHQ-9 Scale [ Time Frame: Baseline, 2, 6 and 12 weeks ]Measures severity of depressive symptoms.
- Change in Scores on SF-12 Scale [ Time Frame: Baseline, 6 and 12 weeks ]A generic measure of function and well being
- Change in Scores on EQ-5D Scale [ Time Frame: Baseline, 6 and 12 weeks ]A generic health-related quality of life index that can be related to costs
- Internet Use Questionnaire [ Time Frame: 12 weeks ]Record of internet resources used relating to health concerns assessed by self-report
- Time Off Work Questionnaire [ Time Frame: 12 weeks ]To assess cost of treatment
- Hospital Admission from ICES data [ Time Frame: 12 weeks ]To assess cost of treatment
- Outpatient appointments from ICES data [ Time Frame: 12 weeks ]To assess cost of treatment
- Medication use from ICES data [ Time Frame: 12 weeks ]To assess cost of treatment
- Demographic Questionnaire [ Time Frame: Baseline ]To describe similarities and differences between the groups
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02423733
|Royal Ottawa Mental Health Centre|
|Ottawa, Ontario, Canada, K1Z 7K4|
|Principal Investigator:||Simon Hatcher, MD.||University of Ottawa|