Please use this identifier to cite or link to this item:
Title: Translating evidence-based psychological interventions for older adults with depression and anxiety into public and private mental health settings using a stepped care framework: Study protocol
Contributor(s): Meuldijk, Denise (author); Wuthrich, Viviana M (author); Rapee, Ronald M (author); Draper, Brian (author); Brodaty, Henry (author); Cuijpers, Pim (author); Cutler, Henry (author); Hobbs, Megan  (author)orcid ; Johnco, Carly (author); Jones, Michael (author); Chen, Jessamine T H (author); Partington, Andrew (author); Wijeratne, Chanaka (author)
Publication Date: 2021-05
Early Online Version: 2021-03-22
DOI: 10.1016/j.cct.2021.106360
Handle Link:
Abstract: Background: With expected increases in the number of older adults worldwide, the delivery of stepped psychological care for depression and anxiety in older populations may improve both treatment and allocative efficiency for individual patients and the health system.
Design: A multisite pragmatic randomised controlled trial evaluating the clinical and cost-effectiveness of a stepped care model of care for treating depression and anxiety among older adults compared to treatment as usual (TAU) will be conducted. Eligible participants (n = 666) with clinically interfering anxiety and/or depression symptoms will be recruited from and treated within six Australian mental health services. The intervention group will complete a low intensity cognitive behavioural therapy (CBT) program: Internet-delivered or using a work-at-home book with brief therapist calls (STEP 1). Following STEP 1 a higher intensity face-to-face CBT (STEP 2) will then be offered if needed. Intention-to-treat analyses will be used to examine changes in primary outcomes (e.g. clinician-rated symptom severity changes) and secondary outcomes (e.g. self-reported symptoms severity, health related quality of life and service utilisation costs). An economic evaluation will be conducted using a cost-utility analysis to derive the incremental cost-effectiveness ratio for the stepped care intervention.
Discussion: This study will demonstrate the relative clinical and economic benefits of stepped care model of psychological care for older adults experiencing anxiety and/or depression compared to TAU. The evaluation of the intervention within existing mental health services means that results will have significant implications for the translation of evidence-based interventions in older adult services across urban and rural settings.
Trail registration: Prospectively registered on (ACTRN12619000219189) and (ISRCTN37503850).
Publication Type: Journal Article
Grant Details: NHMRC/1151138
Source of Publication: Contemporary Clinical Trials, v.104, p. 1-9
Publisher: Elsevier Inc
Place of Publication: United States of America
ISSN: 1559-2030
Field of Research (FoR) 2008: 110319 Psychiatry (incl. Psychotherapy)
111714 Mental Health
170106 Health, Clinical and Counselling Psychology
Field of Research (FoR) 2020: 320221 Psychiatry (incl. psychotherapy)
520302 Clinical psychology
520304 Health psychology
520303 Counselling psychology
Socio-Economic Objective (SEO) 2008: 920410 Mental Health
920209 Mental Health Services
920204 Evaluation of Health Outcomes
Socio-Economic Objective (SEO) 2020: 200409 Mental health
200305 Mental health services
200202 Evaluation of health outcomes
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article
School of Health

Files in This Item:
1 files
File SizeFormat 
Show full item record
Google Media

Google ScholarTM





Items in Research UNE are protected by copyright, with all rights reserved, unless otherwise indicated.