Depression, anxiety, neuroses Mental and Behavioural Disorders Depressive episode
Conditions
Interventions
1. A visit by a specialist nurse within the first week of admission (intervention arm)
2. Put on a waiting list to see a member of the research team at home (control arm)
Sponsors
NHS R&D Regional Programme Register - Department of Health (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients aged 65 years or over, admitted to general medical wards of a district general hospital (West Suffolk Hospital) with a stay over 5 days, over a period of 15 months (January 2002 to March 2003).
Exclusion criteria
Exclusion criteria: 1. Unable to give informed consent to enter the study due to moderate/severe dementia or other reasons 2. No spoken English 3. Dependent upon alcohol or other psychotropic drugs 4. Due to be transferred or discharged on the day of the initial assessment 5. Too physically ill or too confused to be interviewed
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Resolution of ICD10 depression and change in depression rating measured by the Montgomery-Asberg Depression Rating Scale (MADRS) at 16 weeks after the initial assessment compared between intervention and comparison groups, adjusted for severity of disability at baseline. | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in quality of life score (EuroQOL), difference in patient satisfaction (adapted version of patients' satisfaction with stroke services questionnaire), change in carer burden (Caregiver Strain Index and GHQ-12) at 16 weeks after the initial assessment, compared between intervention and comparison groups. (References for standardised measures given in attached research proposal.) Cost-effectiveness ratios for the health benefits resolution of depression, change in depression and quality of life scores) compared to the resource costs in each arm of the study will be calculated. Resources consumed in secondary care (costs of index admission, subsequent inpatient stay and outpatient contact), primary care (GP consultations, contact with nursing staff including specialist psychiatric nurse), and number of hours care from social services will be calculated from routine data sources including hospital information systems, GP and medical records and social services information systems. The economic impact of the intervention upon patients and their carers will also be evaluated. | — |
Countries
United Kingdom
Outcome results
None listed