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Clinical Investigation of Wysa

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05533190
Recruitment Status : Not yet recruiting
First Posted : September 8, 2022
Last Update Posted : November 2, 2022
Sponsor:
Collaborators:
Institute of Cancer Research, United Kingdom
Imperial College London
University of Warwick
University of Oxford
Information provided by (Responsible Party):
Edward Meinert, PhD, University of Plymouth

Brief Summary:

Mental health concerns are a large burden for individuals, healthcare systems, and the economy. Over a million people are referred to UK mental health services each year, but more than half only receive one session of workbook-based support. Many others have to wait over 12 weeks for assessment and treatment. Wysa is a digital health app with over 3 million users that uses an artificial intelligence (AI) chatbot and a series of self-care exercises to provide mental health support and to help people develop strategies to manage their mental health and improve their resilience.

This project aims to examine the impact of using Wysa on patients' symptoms of anxiety and depression during the referral process for standard UK mental health services. Patients will be given access to Wysa at the point of referral to the Improving Access to Psychological Therapies (IAPT) programme and can begin to explore the self-support tools, while they are on the waitlist for assessment and treatment. The investigators will gather a group of patients and members of the public to contribute to the recruitment of patients for the study, the methods we use to evaluate Wysa, and to provide insights on how best to share the results of our study with the general public.

The investigators will use the standard IAPT measures of anxiety and depression to look at the effect of using Wysa patients' mental well-being. These questionnaires will be provided through the app and the results will be compared with a waitlist control group. The investigators will examine whether Wysa can identify people who are experiencing severe mental health difficulties so that they can be provided with additional support. Users' levels of engagement with Wysa will be assessed and some participants will be randomly selected to do an interview so the investigators can get a better understanding of what people liked and disliked about using the app and why. Finally, the investigators will be evaluating the cost-effectiveness of Wysa compared with usual care.

The investigators expect that the study will show that Wysa helps reduce symptoms of anxiety and depression in people who are on the waiting list for IAPT. If the study shows this positive impact, this will provide evidence to support the use of Wysa to improve the accessibility of mental health support in clinical pathways. The investigators will be publishing the results of our study in academic journals as well as in more generally accessible platforms.


Condition or disease Intervention/treatment Phase
Mental Health Issue Anxiety Depressive Symptoms Device: Wysa AI chatbot mental health app Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 480 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Participants will be randomly allocated to the intervention condition or a standard care waitlist control condition.
Masking: None (Open Label)
Masking Description: Due to the nature of the intervention, no blinding of participants will be possible in the study, as all participants will know whether or not they are using the app. Clinical treatment teams will also not be blinded as they will know through the electronic patient record if a participant has received the intervention. The evaluation team will be blinded to treatment using the randomisation algorithm.
Primary Purpose: Treatment
Official Title: Real World Testing of an Artificial Intelligence-enabled App as an Early Intervention and Support Tool in the Mental Health Referral Care Pathway
Estimated Study Start Date : November 7, 2022
Estimated Primary Completion Date : August 1, 2023
Estimated Study Completion Date : August 1, 2023

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Wysa AI chatbot mental health app
Wysa is a guided self-help and triaging tool delivered to patients via an app or widget. It uses Natural Language Processing to understand individuals' written inputs but not to generate responses. Wysa makes use of a wide range of clinically underpinned modules whilst gamification, clinical outcome measures and AI promotes engagement, improving efficacy and triage and reducing the cost of scale.
Device: Wysa AI chatbot mental health app
Wysa is a guided self-help and triaging tool delivered to patients via an app. It includes a chatbot and makes use of a wide range of clinically underpinned modules to provide mental health support.

No Intervention: Waitlist control
The intervention will be compared against a waitlist group. This comparator was selected to compare Wysa to the current standard of care for patients waiting for standard IAPT assessment and treatment.



Primary Outcome Measures :
  1. Depression severity [ Time Frame: 3 months post-randomisation ]
    Score on the PHQ-9, total scores range from 0 to 27 (higher scores indicated more severe depression)


Secondary Outcome Measures :
  1. Anxiety severity [ Time Frame: 3 months post-randomisation ]
    Score on the GAD-7, total scores range from 0 to 21 (higher scores indicated more severe anxiety)

  2. Crisis identification [ Time Frame: Over 9 month intervention period ]
    Number of users identified by the app for escalation of care compared to the number of patients in the control group who access A&E or out-of-hours services while waiting for treatment

  3. Uptake rates [ Time Frame: Over 9 month intervention period ]
    Uptake rates of participants randomised into intervention group

  4. Dropout rates [ Time Frame: Over 9 month intervention period ]
    Dropout rates of participants who are randomised into intervention group and start using the app

  5. App usage data [ Time Frame: Over 9 month intervention period ]
    Frequency and duration of app use

  6. Engagement [ Time Frame: Over 9 month intervention period ]
    Qualitative feedback from semi-structured interviews about engagement with the app

  7. Patient perceptions of acceptability [ Time Frame: Over 9 month intervention period ]
    Qualitative feedback from semi-structured interviews about the acceptability of the app

  8. Self-reported acceptability through the app [ Time Frame: Over 9 month intervention period ]
    Automated review questions periodically requested during general use of the tool

  9. General health state [ Time Frame: Measured at baseline and 3 months post-randomisation ]
    Assessed using the EQ-5D-5L, total scores ranging from 5 to 125 (higher scores indicate more severe health problems)

  10. Impact of health on everyday life [ Time Frame: Measured at baseline and 3 months post-randomisation ]
    Assessed using the Short Form 12 (SF-12) health survey, total scores ranging from 0 to 100 (higher scores indicate better physical and mental functioning)

  11. Cost-analysis [ Time Frame: Over 9 month intervention period ]
    Assessed using compiled cost data relating to health and social care service use, medication and treatment use, Wysa's implementation, and patients' personal payments or related productivity losses



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Willing and able to provide informed consent;
  • Aged 18 years or older;
  • Ability to speak English to a secondary school standard;
  • Own a mobile device capable of supporting Wysa;
  • A valid email address;
  • Referred or self-referred to proceed through the standard IAPT care pathway.

Exclusion Criteria:

  • Patients ineligible for the standard IAPT care pathway;
  • Patients with with previous and current known major mental illness such as psychosis, severe depression, any comorbid neurological or neuro-psychiatric condition such as epilepsy;
  • Patients with suicidal ideation;
  • Patients scoring > 15 points on PHQ 9;
  • Patients scoring > GAD - 7
  • Patients with significant cognitive disorders;
  • Patients with noted neurodevelopmental conditions such as autism or ADHD;
  • Patients previously diagnosed with a personality disorder;
  • Patients who been under the care of CMHT or a specialised mental health services in the last 2 years;
  • Patients who failed IAPT previously;
  • Patients with referrals for specialist presentations of pre-existing, diagnosed conditions requiring a specialised assessment beyond the standard clinical pathway;
  • Incapable of self-consent;
  • In a dependent/unequal relationship with the research or care teams or any PPI representatives.

Information from the National Library of Medicine

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): NCT05533190


Contacts
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Contact: Edward Meinert, PhD 01752600600 edward.meinert@plymouth.ac.uk
Contact: Madison Milne-Ives, MSc 01752600600 madison.milne-ives@plymouth.ac.uk

Locations
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United Kingdom
University of Plymouth
Plymouth, Devon, United Kingdom, PL4 6DN
Sponsors and Collaborators
University of Plymouth
Institute of Cancer Research, United Kingdom
Imperial College London
University of Warwick
University of Oxford
Investigators
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Principal Investigator: Rohit Shankar, FRCPsych University of Plymouth
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Responsible Party: Edward Meinert, PhD, Associate Professor of eHealth, University of Plymouth
ClinicalTrials.gov Identifier: NCT05533190    
Other Study ID Numbers: AM1000411
First Posted: September 8, 2022    Key Record Dates
Last Update Posted: November 2, 2022
Last Verified: November 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Only the Academic CIs and their research staff will have access to research data.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Edward Meinert, PhD, University of Plymouth:
Artificial Intelligence
Mental Health
Telemedicine
Conversational Agent
Additional relevant MeSH terms:
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Depression
Behavioral Symptoms