The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial

Background Antidepressant medication is commonly used to treat depression. However, many patients do not respond to the first medication prescribed and improvements in symptoms are generally only detectable by clinicians 4–6 weeks after the medication has been initiated. As a result, there is oft...

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Main Authors: Kingslake, Jonathan, Dias, Rebecca, Dawson, Gerard R., Simon, Judit, Goodwin, Guy M., Harmer, Catherine J., Morriss, Richard, Brown, Susan, Guo, Boliang, Dourish, Colin T., Ruhé, Henricus G., Lever, Anne G., Veltman, Dick J., van Schaik, Anneke, Deckert, Jürgen, Reif, Andreas, Stäblein, Michael, Menke, Andreas, Gorwood, Philip, Voegeli, Géraldine, Pérez, Victor, Browning, Michael
Format: Article
Published: BioMed Central 2017
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Online Access:https://eprints.nottingham.ac.uk/48701/
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author Kingslake, Jonathan
Dias, Rebecca
Dawson, Gerard R.
Simon, Judit
Goodwin, Guy M.
Harmer, Catherine J.
Morriss, Richard
Brown, Susan
Guo, Boliang
Dourish, Colin T.
Ruhé, Henricus G.
Lever, Anne G.
Veltman, Dick J.
van Schaik, Anneke
Deckert, Jürgen
Reif, Andreas
Stäblein, Michael
Menke, Andreas
Gorwood, Philip
Voegeli, Géraldine
Pérez, Victor
Browning, Michael
author_facet Kingslake, Jonathan
Dias, Rebecca
Dawson, Gerard R.
Simon, Judit
Goodwin, Guy M.
Harmer, Catherine J.
Morriss, Richard
Brown, Susan
Guo, Boliang
Dourish, Colin T.
Ruhé, Henricus G.
Lever, Anne G.
Veltman, Dick J.
van Schaik, Anneke
Deckert, Jürgen
Reif, Andreas
Stäblein, Michael
Menke, Andreas
Gorwood, Philip
Voegeli, Géraldine
Pérez, Victor
Browning, Michael
author_sort Kingslake, Jonathan
building Nottingham Research Data Repository
collection Online Access
description Background Antidepressant medication is commonly used to treat depression. However, many patients do not respond to the first medication prescribed and improvements in symptoms are generally only detectable by clinicians 4–6 weeks after the medication has been initiated. As a result, there is often a long delay between the decision to initiate an antidepressant medication and the identification of an effective treatment regimen. Previous work has demonstrated that antidepressant medications alter subtle measures of affective cognition in depressed patients, such as the appraisal of facial expression. Furthermore, these cognitive effects of antidepressants are apparent early in the course of treatment and can also predict later clinical response. This trial will assess whether an electronic test of affective cognition and symptoms (the Predicting Response to Depression Treatment Test; PReDicT Test) can be used to guide antidepressant treatment in depressed patients and, therefore, hasten treatment response compared to a control group of patients treated as usual. Methods/design The study is a randomised, two-arm, multi-centre, open-label, clinical investigation of a medical device, the PReDicT Test. It will be conducted in five European countries (UK, France, Spain, Germany and the Netherlands) in depressed patients who are commencing antidepressant medication. Patients will be randomised to treatment guided by the PReDicT Test (PReDicT arm) or to Treatment as Usual (TaU arm). Patients in the TaU arm will be treated as per current standard guidelines in their particular country. Patients in the PReDicT arm will complete the PReDicT Test after 1 (and if necessary, 2) weeks of treatment. If the test indicates non-response to the treatment, physicians will be advised to immediately alter the patient’s antidepressant therapy by dose escalation or switching to another compound. The primary outcome of the study is the proportion of patients showing a clinical response (defined as 50% or greater decrease in baseline scores of depression measured using the Quick Inventory of Depressive Symptoms – Self-Rated questionnaire) at week 8. Health economic and acceptability data will also be collected and analysed. Discussion This trial will test the clinical efficacy, cost-effectiveness and acceptability of using the novel PReDicT Test to guide antidepressant treatment selection in depressed patients.
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spelling nottingham-487012020-05-04T19:19:18Z https://eprints.nottingham.ac.uk/48701/ The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial Kingslake, Jonathan Dias, Rebecca Dawson, Gerard R. Simon, Judit Goodwin, Guy M. Harmer, Catherine J. Morriss, Richard Brown, Susan Guo, Boliang Dourish, Colin T. Ruhé, Henricus G. Lever, Anne G. Veltman, Dick J. van Schaik, Anneke Deckert, Jürgen Reif, Andreas Stäblein, Michael Menke, Andreas Gorwood, Philip Voegeli, Géraldine Pérez, Victor Browning, Michael Background Antidepressant medication is commonly used to treat depression. However, many patients do not respond to the first medication prescribed and improvements in symptoms are generally only detectable by clinicians 4–6 weeks after the medication has been initiated. As a result, there is often a long delay between the decision to initiate an antidepressant medication and the identification of an effective treatment regimen. Previous work has demonstrated that antidepressant medications alter subtle measures of affective cognition in depressed patients, such as the appraisal of facial expression. Furthermore, these cognitive effects of antidepressants are apparent early in the course of treatment and can also predict later clinical response. This trial will assess whether an electronic test of affective cognition and symptoms (the Predicting Response to Depression Treatment Test; PReDicT Test) can be used to guide antidepressant treatment in depressed patients and, therefore, hasten treatment response compared to a control group of patients treated as usual. Methods/design The study is a randomised, two-arm, multi-centre, open-label, clinical investigation of a medical device, the PReDicT Test. It will be conducted in five European countries (UK, France, Spain, Germany and the Netherlands) in depressed patients who are commencing antidepressant medication. Patients will be randomised to treatment guided by the PReDicT Test (PReDicT arm) or to Treatment as Usual (TaU arm). Patients in the TaU arm will be treated as per current standard guidelines in their particular country. Patients in the PReDicT arm will complete the PReDicT Test after 1 (and if necessary, 2) weeks of treatment. If the test indicates non-response to the treatment, physicians will be advised to immediately alter the patient’s antidepressant therapy by dose escalation or switching to another compound. The primary outcome of the study is the proportion of patients showing a clinical response (defined as 50% or greater decrease in baseline scores of depression measured using the Quick Inventory of Depressive Symptoms – Self-Rated questionnaire) at week 8. Health economic and acceptability data will also be collected and analysed. Discussion This trial will test the clinical efficacy, cost-effectiveness and acceptability of using the novel PReDicT Test to guide antidepressant treatment selection in depressed patients. BioMed Central 2017-11-23 Article PeerReviewed Kingslake, Jonathan, Dias, Rebecca, Dawson, Gerard R., Simon, Judit, Goodwin, Guy M., Harmer, Catherine J., Morriss, Richard, Brown, Susan, Guo, Boliang, Dourish, Colin T., Ruhé, Henricus G., Lever, Anne G., Veltman, Dick J., van Schaik, Anneke, Deckert, Jürgen, Reif, Andreas, Stäblein, Michael, Menke, Andreas, Gorwood, Philip, Voegeli, Géraldine, Pérez, Victor and Browning, Michael (2017) The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial. Trials, 18 (1). 558/1-558/10. ISSN 1745-6215 Depression; Prediction; Treatment; Antidepressant; Primary care https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-2247-2 doi:10.1186/s13063-017-2247-2 doi:10.1186/s13063-017-2247-2
spellingShingle Depression; Prediction; Treatment; Antidepressant; Primary care
Kingslake, Jonathan
Dias, Rebecca
Dawson, Gerard R.
Simon, Judit
Goodwin, Guy M.
Harmer, Catherine J.
Morriss, Richard
Brown, Susan
Guo, Boliang
Dourish, Colin T.
Ruhé, Henricus G.
Lever, Anne G.
Veltman, Dick J.
van Schaik, Anneke
Deckert, Jürgen
Reif, Andreas
Stäblein, Michael
Menke, Andreas
Gorwood, Philip
Voegeli, Géraldine
Pérez, Victor
Browning, Michael
The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
title The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
title_full The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
title_fullStr The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
title_full_unstemmed The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
title_short The effects of using the PReDicT Test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
title_sort effects of using the predict test to guide the antidepressant treatment of depressed patients: study protocol for a randomised controlled trial
topic Depression; Prediction; Treatment; Antidepressant; Primary care
url https://eprints.nottingham.ac.uk/48701/
https://eprints.nottingham.ac.uk/48701/
https://eprints.nottingham.ac.uk/48701/