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Open Access Study protocol

Predicting outcome following psychological therapy in IAPT (PROMPT): a naturalistic project protocol

Nina Grant1*, Matthew Hotopf2, Gerome Breen3, Anthony Cleare2, Nick Grey4, Nilay Hepgul5, Sinead King5, Paul Moran5, Carmine M Pariante2, Janet Wingrove6, Allan H Young7 and André Tylee5

Author Affiliations

1 Department of Psychology, Institute of Psychiatry, King’s College London, London, UK

2 Department of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK

3 MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK

4 Centre for Anxiety Disorders and Trauma, South London & Maudsley NHS Foundation Trust, London, UK

5 Health Services and Population Research, Institute of Psychiatry, King’s College London, London, UK

6 Southwark Psychological Therapies Service, South London & Maudsley NHS Foundation Trust, London, UK

7 Centre for Affective Disorders, Institute of Psychiatry, King’s College London, London, UK

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BMC Psychiatry 2014, 14:170  doi:10.1186/1471-244X-14-170

Published: 9 June 2014

Abstract

Background

Depression and anxiety are highly prevalent and represent a significant and well described public health burden. Whilst first line psychological treatments are effective for nearly half of attenders, there remain a substantial number of patients who do not benefit. The main objective of the present project is to establish an infrastructure platform for the identification of factors that predict lack of response to psychological treatment for depression and anxiety, in order to better target treatments as well as to support translational and experimental medicine research in mood and anxiety disorders.

Methods/design

Predicting outcome following psychological therapy in IAPT (PROMPT) is a naturalistic observational project that began patient recruitment in January 2014. The project is currently taking place in Southwark Psychological Therapies Service, an Improving Access to Psychological Therapies (IAPT) service currently provided by the South London and Maudsley NHS Foundation Trust (SLaM). However, the aim is to roll-out the project across other IAPT services. Participants are approached before beginning treatment and offered a baseline interview whilst they are waiting for therapy to begin. This allows us to test for relationships between predictor variables and patient outcome measures. At the baseline interview, participants complete a diagnostic interview; are asked to give blood and hair samples for relevant biomarkers, and complete psychological and social questionnaire measures. Participants then complete their psychological therapy as offered by Southwark Psychological Therapies Service. Response to psychological therapy will be measured using standard IAPT outcome data, which are routinely collected at each appointment.

Discussion

This project addresses a need to understand treatment response rates in primary care psychological therapy services for those with depression and/or anxiety. Measurement of a range of predictor variables allows for the detection of bio-psycho-social factors which may be relevant for treatment outcome. This will enable future clinical decision making to be based on the individual needs of the patient in an evidence-based manner. Moreover, the identification of individuals who fail to improve following therapy delivered by IAPT services could be utilised for the development of novel interventions.