Effectiveness and cost-effectiveness of telephone-based cognitive-behavioural therapy in primary care: study protocol of TIDe - telephone intervention for depression

• Published in: BMC psychiatry Vol. 17; no. 1; p. 263
• Main Authors: Watzke, Birgit, Haller, Elisa, Steinmann, Maya, Heddaeus, Daniela, Härter, Martin, König, Hans-Helmut, Wegscheider, Karl, Rosemann, Thomas
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 19.07.2017; BioMed Central; BMC
• Subjects: Access to mental health services; Acquired immune deficiency syndrome; Adult; AIDS; Antidepressants; Behavior modification; Care and treatment; Clinical Protocols; Cognitive ability; Cognitive behavioral therapy; Cognitive therapy; Cognitive Therapy - economics; Cognitive Therapy - methods; Cost-Benefit Analysis; Depression (Mood disorder); Depression - economics; Depression - therapy; Evidence-based treatment; Female; Humans; Male; Medical research; Mental depression; Mental disorders; Mental health; Mental health care; Mild to moderate depression; Primary care; Primary health care; Primary Health Care - methods; Psychiatry; Psychotherapy; Short-term CBT; Study Protocol; Technology application; Telemedicine; Telephone; Telephone-delivered psychotherapy; Therapy, Computer-Assisted; Switzerland; Telephone-delivered psychotherapy; Access to mental health services; Mild to moderate depression; Primary care; Evidence-based treatment; Short-term CBT
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-017-1429-5

Despite the availability of evidence-based treatments for depression, a large proportion of patients remains untreated or adequate treatment is initiated with delay. This situation is particularly critical in primary care, where not only most individuals first seek help for their mental health problems, but also depressive disorders - particularly mild to moderate levels of severity - are highly prevalent given the high comorbidity of chronic somatic conditions and depression. Improving the access for evidence-based treatment, especially in primary care, is hence a priority challenge in the mental health care agenda. Telephone usage is widespread and has the potential of overcoming many barriers that individuals suffering from mental health problems are facing: Its implementation for treatment delivery presents an option for optimisation of treatment pathways and outcomes. This paper details the study protocol for a randomised controlled trial (RCT) evaluating the effectiveness of a telephone-administered short-term cognitive-behavioural therapy (T-CBT) for depression as compared to treatment as usual (TAU) in the Swiss primary care setting. The study aims at randomising a total of 216 mildly to moderately depressed patients, which are either identified by their General Practitioners (GPs) or who self-refer to the study programme in consultation with their GP. The trial will examine whether telephone-delivered, manualised treatment leads to clinically significant reduction in depression at follow-up. It will further investigate the cost-effectiveness and acceptability of the intervention in the primary care setting. Conducting a low-intensity treatment on the telephone allows for greater flexibility for both patient and therapist, can grant more anonymity and can thus lead to less hesitation in the patient about whether to attempt treatment or not. In order to benefit from this approach, large-scale studies need to prove superior effectiveness and cost-effectiveness of telephone-delivered therapy over routine care for patients with mild to moderate depression. ClinicalTrials.gov NCT02667366 . Registered on 3 December 2015.