Outcomes of telephone-delivered low-intensity cognitive behaviour therapy (LiCBT) to community dwelling Australians with a recent hospital admission due to depression or anxiety: MindStep™

Autor: Fiona Glover, Jane Cameron, Paula Redpath, David Smith, Kate Fairweather-Schmidt, Malcolm Battersby, Sara Zabeen, Sharon Lawn, Nancy Huang, Anthony Venning
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
lcsh:RC435-571
Prevention and early intervention
Anxiety
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Intervention (counseling)
lcsh:Psychiatry
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Improving access to psychological therapies
Psychiatry
Depression (differential diagnoses)
Depressive Disorder
Cognitive Behavioral Therapy
business.industry
Depression
Community mental health service
Australia
Improving Access to Psychological Therapies
Private health insurance
Middle Aged
Hospital admission
Anxiety Disorders
Mental health
Low-intensity cognitive behaviour therapy
Telemedicine
Telephone
030227 psychiatry
Hospitalization
Patient Health Questionnaire
Psychiatry and Mental health
Patient Satisfaction
Cohort
Feasibility Studies
Female
Observational study
Independent Living
medicine.symptom
business
Research Article
Zdroj: BMC Psychiatry, Vol 19, Iss 1, Pp 1-16 (2019)
BMC Psychiatry
Popis: Background In 2006, the British government launched ‘Improving Access to Psychological Therapies’ (IAPT), a low intensity cognitive behaviour therapy intervention (LiCBT) designed to manage people with symptoms of anxiety and depression in the community. The evidence of the effectiveness of IAPT has been demonstrated in multiple studies from the UK, USA, Australia and other countries. MindStep™ is the first adaptation of IAPT in Australia, delivered completely by telephone, targeting people with a recent history of a hospital admission for mental illnesses within the private health system. This paper reports on the outcome of the first 17 months of MindStep™ implemented across Australia from March 2016. Methods This prospective observational study investigated the MindStep™ program in a cohort of clients with a recent hospitalisation for mental illnesses. The study used quantitative methods to compare pre-post treatment clinical measures (N = 680) using Patient Health Questionnaire (PHQ-9) and the Generalised Anxiety Disorder (GAD-7). This study also included in-depth interviews with participants (N = 14) and coaches (N = 4) to determine the feasibility and acceptability of the program. Results Of the 867 clients referred to MindStep™, 757 had initial assessments by phone making an enrolment rate of 87.3%. Following assessment, 680 commenced treatment and of them, 427 (62.7%) completed treatment. According to ‘per-protocol’ analysis (N = 427), there was a large effect size for post-treatment PHQ-9 (d = 1.03) and GAD-7 (d = 0.99) scores; reliable recovery rate was 62% (95% CI: 57–68%). For intent-to-treat analysis using multiple imputation (N = 680), effect sizes were also large for pre-post treatment change: PHQ-9 (d = 0.78) and GAD-7 (d = 0.76). The reliable recovery rate was 49% (95% CI: 45–54%). Qualitative findings supported these claims where participants were positive about MindStep™ and found the telephone delivery and use of mental health coaches highly acceptable. Conclusions MindStep™ has demonstrated encouraging outcomes that suggest LiCBT can be successfully delivered to people with a history of hospital admissions for anxiety and depressive disorders and achieve target recovery rates of > 50%. Other promising evaluation findings indicate the MindStep™ option is acceptable, feasible and safe within the stepped models of mental health care delivery in Australia. Electronic supplementary material The online version of this article (10.1186/s12888-018-1987-1) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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