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

Birgit Watzke, Elisa Haller, Maya Steinmann, Daniela Heddaeus, Martin Härter, Hans-Helmut König, Karl Wegscheider, Thomas Rosemann, Birgit Watzke, Elisa Haller, Maya Steinmann, Daniela Heddaeus, Martin Härter, Hans-Helmut König, Karl Wegscheider, Thomas Rosemann

Abstract

Background: 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.

Methods/design: 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.

Discussion: 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.

Trial registration: ClinicalTrials.gov NCT02667366 . Registered on 3 December 2015.

Keywords: Access to mental health services; Evidence-based treatment; Mild to moderate depression; Primary care; Short-term CBT; Telephone-delivered psychotherapy.

Conflict of interest statement

Ethics approval and consent to participate

The proposed study has been approved by the responsible local Ethics Committee of the Canton of Zurich (Kantonale Ethikkomission Zürich) on 23 November 2015 (Ref. Nr. 2015–0417). Approval for amendments to the protocol will be sought by the Ethics Committee, which will be updated further in the trial registry at ClinicalTrials.gov.

Consent for publication

Not applicable.

Competing interests

All authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
SPIRIT flowchart of study participants

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Source: PubMed

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