StratCare Trial
Research type
Research Study
Full title
Pragmatic randomised controlled trial of a stratified care model for depression and anxiety
IRAS ID
247945
Contact name
Jaime Delgadillo
Contact email
Sponsor organisation
University of Sheffield
ISRCTN Number
ISRCTN00000000
Clinicaltrials.gov Identifier
applied; number to be confirmed, ISRCTN**
Duration of Study in the UK
1 years, 5 months, 25 days
Research summary
Patients with depression and anxiety problems accessing the English National Health Service are commonly referred for psychological treatment in IAPT services (Improving Access to Psychological Therapies). IAPT services organise treatment in a stepped care model, where most patients tend to initially receive brief and low intensity interventions prior to accessing more intensive psychological therapies if required. Recent studies have shown that some patients with more complex clinical presentations tend to drop out and have poor outcomes in low intensity treatments, but they respond better to high intensity treatments. These studies have suggested that referring 'complex cases' directly to high intensity treatments (stratified care) could considerably improve their likelihood of improvement in depression symptoms. However, this evidence comes from analyses of historical routine care data, and no studies to date have tested the effect of this stratified care model in a prospective trial.
The aim of this study is to compare the effectiveness of a stratified care model (where complex cases are matched to high intensity treatments) versus usual stepped-care, in a pragmatic cluster randomised controlled trial. Therapists will be randomised to a StratCare group or a usual care control group. Those in the StratCare group will be trained to use a computer programme that will help them to identify complex cases and to adequately refer these to high intensity treatments. Control group therapists will assess patients and make referral for treatment in the usual way (based on their clinical judgment).
REC name
West of Scotland REC 5
REC reference
18/WS/0114
Date of REC Opinion
18 Jul 2018
REC opinion
Further Information Favourable Opinion