Behavioural activation in nursing homes to treat depression (BAN-Dep): study protocol for a pragmatic randomised controlled trial

• Published in: BMJ open Vol. 9; no. 10; p. e032421
• Main Authors: Velasquez Reyes, Diana, Patel, Hema, Lautenschlager, Nicola, Ford, Andrew H, Curran, Eleanor, Kelly, Rachael, Lai, Rhoda, Chong, Terence, Flicker, Leon, Ekers, David, Gilbody, Simon, Etherton-Beer, Christopher, Lo Giudice, Dina, Ellis, Kathryn A, Martini, Angelita, Almeida, Osvaldo P
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.10.2019; BMJ Publishing Group
• Subjects: Aged; Antidepressants; Australia; Cognitive Behavioral Therapy - methods; Depression - therapy; Evidence-based medicine; Health Personnel - education; Homes for the Aged - organization & administration; Humans; Mental depression; Mental Health; Multicenter Studies as Topic; Nursing homes; Nursing Homes - organization & administration; Older people; Outcome Assessment, Health Care; Pragmatic Clinical Trials as Topic; Psychotropic drugs; Quality of Life; Surveys and Questionnaires; Systematic review; Australia; randomised controlled trial; depression and mood disorders; behavioural activation; elderly; aged care
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2019-032421

IntroductionDepression is a common disorder among older people living in residential aged care facilities. Several trials have demonstrated the effectiveness of behavioural therapies in treating depressive symptoms in older adults living in the community and in residential aged care. Behavioural Activation is demonstrably effective even when delivered by non-specialists (staff without formal psychological training), although strategies for adapting its use in residential aged care facilities are yet to be explored. This study will determine whether training residential care staff in the use of a structured Behavioural Activation programme is more effective at decreasing depressive symptoms among older residents than internet-based training about depression recognition and management alone.Method and analysisThe behavioural activation in nursing homes to treat depression (BAN-Dep) trial is a pragmatic two-arm parallel clustered randomised controlled trial. It will recruit 666 residents aged 60 or older from 100 residential aged care facilities, which will be randomly assigned to the Behavioural Activation or control intervention. Staff in both treatment groups will be encouraged to complete the Beyondblue Professional Education to Aged Care e-learning programme to improve their recognition of and ability to respond to depression in older adults. Selected staff from intervention facilities will undergo additional training to deliver an 8-module Behavioural Activation programme to residents with subthreshold symptoms of depression-they will receive ongoing Mental support from trained Behavioural Activation therapists. Outcome measures will be collected by blind research officer at baseline and after 3, 6 and 12 months. The Patient Health Questionnaire-9 is the primary outcome measure of the study.Ethics and disseminationThe trial will comply with the principles of the Declaration of Helsinki for Human Rights and is overseen by the University of Western Australia (reference RA/4/20/4234) and Melbourne Health (reference number HREC/18/MH/47) Ethics Committees. The results of this research project will be disseminated through publications and/or presentations in a variety of media to health professionals, academics, clinicians and the public. Only de-identified group data will be presented.Trial registrationACTRN12618000634279.