Consultation-Liaison Intervention for Patients with Depression and Anxiety in Primary Care (CoLiPri)

University of Zurich (UZH)

Status: Completed

Conditions: Depression; Anxiety

Treatments: Behavioral: CoLiPri intervention; Other: Usual primary care enhanced

Study type: Interventional

Funder types: Other

Identifiers

NCT04233853

407440_167436

Details and patient eligibility

About

The CoLiPri study is a cluster randomized controlled trial funded by the Swiss National Science Foundation to evaluate the clinical and cost effectiveness as well as the implementation of a complex consultation-liaison intervention to help improve symptoms of anxiety and depression of screened patients in primary care. The intervention includes expert consultations, on demand referral for structured mental health diagnostics, psychoeducation and treatment planning, as well as brief psychotherapeutic interventions and triage.

Full description

Mental disorders such as depression or anxiety are serious and common health conditions that are highly prevalent in primary care. The primary care sector plays a key role in the treatment of common mental disorders as general practitioners (GPs) set the course for identification, diagnosis, therapy and referral to specialized treatment. The objectives of the CoLiPri study are to implement a complex consultation-liaison service at the intersection between primary and secondary care and to investigate its clinical and cost effectiveness in patients who are identified at primary care practices with elevated symptoms of depression and anxiety. Focus of the complex intervention is on improved collaboration and communication among GPs, mental health experts, and other services involved in the care of patients with common mental disorders. The novel service aims to support the decision-process at primary care practices, to increase access to evidence-based mental health treatment, and to help improve patients' pathways of care. The CoLiPri service for GPs include expert consultations, on-demand patient referral for structured diagnostics, and/or treatment planning, as well as brief psychotherapeutic interventions and triage. The effectiveness and cost effectiveness of the intervention as an add-on to enhanced usual primary care (usual care plus structured depression and anxiety screening) are evaluated in a cluster randomized clinical trial in screened patients with at least mild symptoms of depression and/or anxiety. In case of positive results, the service might serve as a model how to improve multi professional collaboration and clinical resource allocation for better delivery of mental health care.

Enrollment: 82 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients scoring ≥5 on the PHQ-9 and/or scoring ≥5 on the GAD-7
• Presenting and treated at the participating practice
• Sufficient command of the German language
• Individual signed informed consent

Exclusion criteria

• Acute suicidality at the time of enrolment according to clinical evaluation
• A history of psychotic symptoms
• Bipolar Disorder Type-I or Type-II
• Acute substance-related and addictive disorder (i.e. as primary diagnosis)
• Severe cognitive impairment or other serious factors causing inability to follow the procedures of the study

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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82 participants in 2 patient groups

CoLiPri intervention

Experimental group

Description:

General practitioners and their screened patients have access to the consultation-liaison services for a total duration of 12 months, including standard screening, expert consultations, on demand patient referral for structured mental health diagnostics, psychoeducation and treatment planning, as well as brief psychotherapeutic intervention and triage.

Treatment:

Other: Usual primary care enhanced

Behavioral: CoLiPri intervention

Usual primary care enhanced

Active Comparator group

Description:

Usual primary care practice as offered in routine care. Enhanced means that practitioners receive a basic training which consists of guideline-based structured screening procedures for depression and anxiety mental disorders in primary care.

Treatment:

Other: Usual primary care enhanced