OBJECTIVES: To determine the effects of implementing stepped care evidence-based psychological treatments for anxiety and depression in routine practice using a collaborative care implementation model. DESIGN: Observational prospective cohort study/Phase IV field trial. METHODS: We collected data on depression and anxiety from a prospective cohort of 3,994 consecutive patients referred to the UK Improving Access to Psychological Therapies demonstration site in Doncaster for 12 months from August 2006 using PHQ-9 and GAD-7. We collected demographic and process information including the type and methods of treatments received. We calculated effect sizes, remission, and recovery rates for patients competing treatment and those who dropped out or were considered to be unsuitable. RESULTS: Two thousand seven hundred and ninety-five patients received an assessment, out of which 2,017 received two or more appointments. Out of these, 869 had completed treatment by the census date, 743 remained in treatment, 319 had dropped out, and 85 had been found to be unsuitable. Pre-post treatment effect sizes for anxiety and depression in those patients completing treatment were 1.39 and 1.41, respectively, with post-treatment relative risks of depression and anxiety 0.29 and 0.34. The combined remission and recovery rates were 76% for depression and 74% for anxiety. The mean number of treatment sessions was 5.15 in a mean time of 2 h and 45 min. On an average, patients received at least three of these contacts by telephone. Outcomes are comparable with benchmarked trials, reviews, and routine datasets. CONCLUSIONS: Combining low-intensity stepped care psychological treatment with a telephony-based collaborative care organizational system can deliver good clinical outcomes in routine practice.
OBJECTIVES: To determine the effects of implementing stepped care evidence-based psychological treatments for anxiety and depression in routine practice using a collaborative care implementation model. DESIGN: Observational prospective cohort study/Phase IV field trial. METHODS: We collected data on depression and anxiety from a prospective cohort of 3,994 consecutive patients referred to the UK Improving Access to Psychological Therapies demonstration site in Doncaster for 12 months from August 2006 using PHQ-9 and GAD-7. We collected demographic and process information including the type and methods of treatments received. We calculated effect sizes, remission, and recovery rates for patients competing treatment and those who dropped out or were considered to be unsuitable. RESULTS: Two thousand seven hundred and ninety-five patients received an assessment, out of which 2,017 received two or more appointments. Out of these, 869 had completed treatment by the census date, 743 remained in treatment, 319 had dropped out, and 85 had been found to be unsuitable. Pre-post treatment effect sizes for anxiety and depression in those patients completing treatment were 1.39 and 1.41, respectively, with post-treatment relative risks of depression and anxiety 0.29 and 0.34. The combined remission and recovery rates were 76% for depression and 74% for anxiety. The mean number of treatment sessions was 5.15 in a mean time of 2 h and 45 min. On an average, patients received at least three of these contacts by telephone. Outcomes are comparable with benchmarked trials, reviews, and routine datasets. CONCLUSIONS: Combining low-intensity stepped care psychological treatment with a telephony-based collaborative care organizational system can deliver good clinical outcomes in routine practice.
Authors: David A Richards; Peter Bower; Christina Pagel; Alice Weaver; Martin Utley; John Cape; Steve Pilling; Karina Lovell; Simon Gilbody; Judy Leibowitz; Lilian Owens; Roger Paxton; Sue Hennessy; Angela Simpson; Steve Gallivan; David Tomson; Christos Vasilakis Journal: Implement Sci Date: 2012-01-16 Impact factor: 7.327
Authors: Raeanne C Moore; Elizabeth A Chattillion; Jennifer Ceglowski; Jennifer Ho; Roland von Känel; Paul J Mills; Michael G Ziegler; Thomas L Patterson; Igor Grant; Brent T Mausbach Journal: Behav Res Ther Date: 2013-07-19
Authors: Nicole M Alberts; Wendy M Leisenring; Jessica S Flynn; Jillian Whitton; Todd M Gibson; Lindsay Jibb; Aaron McDonald; James Ford; Neema Moraveji; Blake F Dear; Kevin R Krull; Leslie L Robison; Jennifer N Stinson; Gregory T Armstrong Journal: JCO Clin Cancer Inform Date: 2020-11
Authors: Lina Gega; Louise Swift; Garry Barton; Gillian Todd; Nesta Reeve; Kelly Bird; Richard Holland; Amanda Howe; Jon Wilson; Jo Molle Journal: Trials Date: 2012-08-27 Impact factor: 2.279