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

NCT ID: NCT04233853

Last Updated: 2025-02-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 82 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-01-13
• Study Completion Date: 2024-04-14

Brief Summary

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.

Detailed 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.

Conditions

Depression; Anxiety

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

CoLiPri intervention

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.

Group Type: EXPERIMENTAL

CoLiPri intervention

Intervention Type: BEHAVIORAL

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.

Usual primary care enhanced

Intervention Type: OTHER

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.

Usual primary care enhanced

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.

Group Type: ACTIVE_COMPARATOR

Usual primary care enhanced

Intervention Type: OTHER

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.

Interventions

CoLiPri intervention

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.

Intervention Type: BEHAVIORAL

Usual primary care enhanced

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.

Intervention Type: OTHER

Other Intervention Names

Consultation-liaison service

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Heidelberg University

OTHER

Sponsor Role: collaborator

University of Zurich

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Birgit Watzke, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University of Zurich

Markus Wolf, Dr.

Role: PRINCIPAL_INVESTIGATOR

University of Zurich

Locations

University of Zurich

Zurich, , Switzerland

Countries

Switzerland

Related Links

http://www.colipri.uzh.ch/de

Official website of the CoLiPri project (in German)

https://www.nfp74.ch/en/mpSTKsuFOIsU3w5B/project/project-watzke

Brief project description at the SNSF National Research Program 74 "Smarter Healthcare"

Other Identifiers

407440_167436

Identifier Type: -

Identifier Source: org_study_id