Completed Mental Health Psychology & Behaviour

Multi-centre Randomised Controlled Trial of Collaborative Care for Depression

Funder MRC (part of UKRI)
Recipient organisation University of Exeter Source-published name: University of Exeter
Funding £1.8M
Period Aug 2008 — Aug 2012

In plain English

AI plain-English summary

A specially trained case manager will be assigned to each depressed patient in a large UK trial to test whether intensive telephone support and coordinated care can double the success rate of GP treatment. Depression affects more people worldwide than any condition except heart disease, yet many patients fail to improve because they lack ongoing support between GP visits. Current treatment often breaks down when patients struggle alone with medication side effects or cannot access psychological help. This trial directly tests whether a dedicated case manager—who stays in regular phone contact, coordinates with GPs and mental health specialists, and tailors treatment plans—can close that gap. If collaborative care proves more effective than standard GP treatment and is cost-effective, the researchers aim to make it the recommended approach across UK primary care. That would mean tens of thousands of patients each year receiving structured, sustained support rather than a prescription and a follow-up appointment months later. The economic analysis will also tell the NHS whether the upfront cost of case managers is offset by reduced hospital visits and fewer workdays lost to depression.

View original technical description
Depression causes misery to many people in the UK. Worldwide, more people are affected by depression than any other condition apart from heart disease. Depressed people find it difficult to work and engage in meaningful activity. Depression affects individuals, their families, friends and their communities. Improving treatment for depression in primary care could have a major positive impact on patients, their families and society. Although effective treatments are available from GPs in primary care, many patients need additional support whilst they are being treated. Lack of this support often causes treatment to fail. An exciting new way of organising treatment ? ?collaborative care? ? has been shown to be effective in the United States. This treatment involves allocating a specially trained worker ? a ?case manager? ? to patients with depression. The case manager works with patients, GPs and mental health specialists to agree individual treatment plans for patients. The case manager then keeps in close touch with patients to make this plan work. This plan includes regular telephone contact with patients, support to those who are taking medication and advice about psychological ways to improve depression. The case manager accesses regular advice from psychiatrists and psychologists and ensures that the patient?s GP is fully involved in the treatment plan. Recently, three research groups in the UK have demonstrated that it may be possible to adapt these methods of working for the UK. These groups have now come together to plan a large clinical trial in the UK which will thoroughly test this new approach. The research study will test collaborative care by allocating consenting patients to either collaborative care or to the care a patient would usually receive from their GP. We will carefully measure patients? symptoms of depression before the study and after four months to test if patients receiving collaborative care are more improved that those receiving usual care from their GP. We will also assess patients? symptoms again after 12 months. In addition, we will count the extent to which patients have used other health services and do an economic analysis to see if collaborative care is cost effective. If, as we suspect, we are able to show that people receiving collaborative care improve more than people receiving usual care and that this is cost effective, we will ensure that collaborative care becomes the recommended way of supporting the treatment of people with depression in primary care.

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Researchers

Chew-Graham Carolyn (Co-Investigator)Chris Manning (Co-Investigator)Christine Godfrey (Co-Investigator)David Kessler (Co-Investigator)David Richards (Principal Investigator)David Torgerson (Co-Investigator)Glyn Lewis (Co-Investigator)John Cape (Co-Investigator)Karina Lovell (Co-Investigator)Linda Gask (Co-Investigator)Martin Bland (Co-Investigator)Michael Barkham (Co-Investigator)Peter Bower (Co-Investigator)Ricardo Araya (Co-Investigator)Simon Gilbody (Co-Investigator)Stephen Pilling (Co-Investigator)

Related Research

Grants with similar aims, by meaning.

Characteristics of patient populations that determine the effectiveness of collaborative care interventions for depression: meta-analysis of individual participant data in people with long term conditions
Collaborative care and active surveillance for screen-positive elders with sub-clinical depression: a pilot study and definitive and randomised evaluation - the CASPER trial
Primary care patients’ views and experiences of treatments for depression, and of those delivering their care: a secondary analysis of qualitative data
Optimising the depression pathway enabled by novel digital assessment technology
Integrated therapist and online CBT for depression in primary care

Original classification

Research Grant

Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.