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A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment

Tylee, Andre, Haddad, Mark, Barley, Elizabeth, Ashworth, Mark, Brown, June, Chambers, John, Farmer, Anne, Fortune, Zoe, Lawton, Rebecca, Leese, Morven , Mann, Anthony, McCrone, Pual, Murray, Joanna, Pariante, Carmine, Phillips, Rachel, Rose, Diana, Rowlands, Gill, Sabes-Figuera, Ramon, Smith, Alison and Walters, Paul (2012) A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment BMC Psychiatry, 12, 58.

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Background: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings.Methods: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care.81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of �8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire.Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant's physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant's mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient's self efficacy to solve their problems.Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation.Discussion: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care.Trial registration: ISRCTN21615909. © 2012 Tylee et al.; licensee BioMed Central Ltd.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Health Sciences
Authors :
Tylee, Andre
Haddad, Mark
Ashworth, Mark
Brown, June
Chambers, John
Farmer, Anne
Fortune, Zoe
Lawton, Rebecca
Leese, Morven
Mann, Anthony
McCrone, Pual
Murray, Joanna
Pariante, Carmine
Phillips, Rachel
Rose, Diana
Rowlands, Gill
Sabes-Figuera, Ramon
Walters, Paul
Date : 6 June 2012
DOI : 10.1186/1471-244X-12-58
Copyright Disclaimer : © 2012 Tylee et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords : adult, article, case management, controlled study, follow up, general practice, human, ischemic heart disease, major clinical study, major depression, methodology, patient participation, personalized medicine, pilot study, randomized controlled trial, self concept, symptom, teleconsultation, United Kingdom, Article, behavior change, depression, general practitioner, health care need, health care utilization, Hospital Anxiety and Depression Scale, Hospital Anxiety and Depression Scale depression subscale, mental health, Modified Rose Angina Questionnaire, mood, patient care, personalized medicine, psychologic test, quality of life, questionnaire, single blind procedure, wellbeing, Clinical Protocols, Coronary Disease, Depressive Disorder, Humans, Patient Selection, Pilot Projects, Research Design
Depositing User : Diane Maxfield
Date Deposited : 19 Jul 2019 15:20
Last Modified : 19 Jul 2019 15:20

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