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Randomized Controlled Trial
. 2022 Sep 9;22(1):598.
doi: 10.1186/s12888-022-04227-0.

Long-term outcomes at 24- and 36-month follow-up in the intervention arm of the randomized controlled trial of Prompt Mental Health Care

Otto R F Smith  1   2   3 , Solbjørg M M Sæther  4 , Ellen Haug  5   6 , Marit Knapstad  4
Affiliations
Randomized Controlled Trial

Long-term outcomes at 24- and 36-month follow-up in the intervention arm of the randomized controlled trial of Prompt Mental Health Care

Otto R F Smith et al. BMC Psychiatry. .

Abstract

Background: Whether long-term symptom improvement is maintained after treatment in services such as the Norwegian Prompt Mental Health Care (PMHC) and the English Improving Access to Psychological Therapies is not yet known. In this prospective study, we investigate whether improvements observed at 6-month follow-up are maintained at 24- and 36-month follow-up among clients who received PMHC.

Method: Data from the treatment arm of the randomized controlled trial of PMHC were used (n = 459). The main outcomes were (reliable) recovery rate and symptoms of depression (PHQ-9) and anxiety (GAD-7). Primary outcome data at 24- and 36-months follow-up were available for 47% and 39% of participants, respectively. Secondary outcomes were work participation, functional status, health-related quality of life, and positive mental well-being. Sensitivity analyses with regard to missing data assumptions were conducted for the primary continuous outcomes.

Results: Improvements were maintained at 24- and 36-month follow-up for symptoms of depression and anxiety, (reliable) recovery rate, and health-related quality of life. Small linear improvements since 6-month follow-up were observed for work participation, functional status, and positive mental well-being. Sensitivity analyses did not substantially alter the findings for symptoms of depression and anxiety mentioned above.

Conclusions: Our findings support the long-term effectiveness of PMHC, but results should be interpreted with caution due to lacking follow-up data at 24- and 36-month in the control group, and substantial attrition.

Keywords: Anxiety; CBT; Depression; IAPT; Long-term outcomes; Prompt Mental Health Care.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow diagram for participants in the RCT of Prompt Mental Health Care
Fig. 2
Fig. 2
Change in mean scores of symptoms of depression (PHQ) and anxiety (GAD) from baseline up to 36-month follow-up. Observed scores in the TAU group are added for illustrative purposes
Fig. 3
Fig. 3
Change in mean scores of symptoms of depression (PHQ) and anxiety (GAD) in the PMHC group across different missing data assumption scenarios. Note that the range of the y-axis has been restricted, which enlarges the difference between the models
See this image and copyright information in PMC

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