Evidence map›Paper›PMID 28249592›Full record

Trial reportTrials2017

A pragmatic randomised controlled trial assessing the non-inferiority of counselling for depression versus cognitive-behaviour therapy for patients in primary care meeting a diagnosis of moderate or severe depression (PRaCTICED): Study protocol for a randomised controlled trial.

David Saxon, Kate Ashley, Lindsey Bishop-Edwards, Janice Connell, Phillippa Harrison, Sally Ohlsen, Gillian E Hardy, Stephen Kellett, Clara Mukuria, Toni Mank and 10 more

Open access · goldAbstract readComparative StudyPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Trials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.7field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 7 institutions in 1 country.

David SaxonHealth Services Research, Centre for Psychological Services Research, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Kate AshleyHealth Services Research, Centre for Psychological Services Research, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Lindsey Bishop-EdwardsHealth Services Research, Centre for Psychological Services Research, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Janice ConnellHealth Services Research, Centre for Psychological Services Research, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Phillippa HarrisonClinical Psychology Unit, Centre for Psychological Services Research, University of Sheffield, Sheffield, S10 2TN, UK.
Sally OhlsenHealth Services Research, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 4DA, UK.
Gillian E HardyClinical Psychology Unit, Centre for Psychological Services Research, University of Sheffield, Sheffield, S10 2TN, UK.
Stephen KellettClinical Psychology Unit, Centre for Psychological Services Research, University of Sheffield, Sheffield, S10 2TN, UK.
Clara MukuriaHealth Economics and Decision Science, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Toni MankSheffield IAPT (Sheffield Health & Social Care NHS Foundation Trust), St George's Community Health Centre, Winter Street, Sheffield, S3 7ND, UK.
Peter BowerNIHR School for Primary Care Research, University of Manchester, Manchester, M13 9PL, UK.
Mike BradburnClinical Trial Research Unit, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
John BrazierHealth Economics and Decision Science, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Robert ElliottCounselling Unit, School of Psychological Sciences and Health, University of Strathclyde, Room 507, Graham Hills Building, 40 George Street, Glasgow, G1 1QE, UK.
Lynne GabrielSchool of Psychological and Social Sciences, York St John University, Lord Mayor's Walk, York, YO31 7EX, UK.
Michael KingDivision of Psychiatry, Faculty of Brain Sciences, University College London, Sixth Floor, Maple House, 149 Tottenham Court Rd, London, W1T 7NF, UK.
Stephen PillingResearch Department of Clinical Health and Educational Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Sue Shawc/o Mental Health Group, Health Services Research, School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 2DA, UK.
Glenn WallerDepartment of Psychology, University of Sheffield, Sheffield, S10 2TN, UK.
Michael BarkhamClinical Psychology Unit, Centre for Psychological Services Research, University of Sheffield, Sheffield, S10 2TN, UK. m.barkham@sheffield.ac.uk.ORCID 0000-0003-1687-6376
University of Sheffield · GBSheffield Health and Social Care NHS Foundation Trust · GBUniversity College London · GBSheffield Hallam University · GBUniversity of Manchester · GBUniversity of Strathclyde · GBYork St John University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNICE guidelines state cognitive behavioural therapy (CBT) is a front-line psychological treatment for people presenting with depression in primary care. Counselling for Depression (CfD), a form of Person-Centred Experiential therapy, is also offered within Improving Access to Psychological Therapies (IAPT) services for moderate depression but its effectiveness for severe depression has not been investigated. A full-scale randomised controlled trial to determine the efficacy and cost-effectiveness of CfD is required.

methodsPRaCTICED is a two-arm, parallel group, non-inferiority randomised controlled trial comparing CfD against CBT. It is embedded within the local IAPT service using a stepped care service delivery model where CBT and CfD are routinely offered at step 3. Trial inclusion criteria comprise patients aged 18 years or over, wishing to work on their depression, judged to require a step 3 intervention, and meeting an ICD-10 diagnosis of moderate or severe depression. Patients are randomised using a centralised, web-based system to CfD or CBT with each treatment being delivered up to a maximum 20 sessions. Both interventions are manualised with treatment fidelity tested via supervision and random sampling of sessions using adherence/competency scales. The primary outcome measure is the Patient Health Questionnaire-9 collected at baseline, 6 and 12 months. Secondary outcome measures tap depression, generic psychological distress, anxiety, functioning and quality of life. Cost-effectiveness is determined by a patient service receipt questionnaire. Exit interviews are conducted with patients by research assessors blind to treatment allocation. The trial requires 500 patients (250 per arm) to test the non-inferiority hypothesis of -2 PHQ-9 points at the one-sided, 2.5% significance level with 90% power, assuming no underlying difference and a standard deviation of 6.9. The primary analysis will be undertaken on all patients randomised (intent to treat) alongside per-protocol and complier-average causal effect analyses as recommended by the extension to the CONSORT statement for non-inferiority trials. DISCUSSION: This large-scale trial utilises routinely collected outcome data as well as specific trial data to provide evidence of the comparative efficacy and cost-effectiveness of Counselling for Depression compared with Cognitive Behaviour Therapy as delivered within the UK government's Improving Access to Psychological Therapies initiative.

trial registrationControlled Trials ISRCTN Registry, ISRCTN06461651 . Registered on 14 September 2014.

Indexed as

Cognitive Behavioral TherapyCounselingPrimary Health CareClinical ProtocolsComparative Effectiveness ResearchCost-Benefit AnalysisDepressionEnglandHealth Care CostsHumansIntention to Treat AnalysisPsychiatric Status Rating ScalesResearch DesignSeverity of Illness IndexSurveys and QuestionnairesTime FactorsCognitive behaviour therapyCounselling for depressionDepressionNon-inferiority trial

Identifiers

PMID28249592
PMCPMC5333411
OpenAlexW2592441628

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.