Evidence map›Paper›PMID 36868594›Full record

Trial reportBMJ open2023

Antidepressant Advisor (ADeSS): a decision support system for antidepressant treatment for depression in UK primary care - a feasibility study.

Phillippa Harrison, Ewan Carr, Kimberley Goldsmith, Allan Young, Mark Ashworth, Diede Fennema, Suqian Duan, Barbara M Barrett, Roland Zahn

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03628027 (The Antidepressant Advisor), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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.

NCT03628027 phase2unknown statusnot on this map

The Antidepressant Advisor: A Decision Support System for UK Primary care-a Feasibility Study

TypeinterventionalSponsorKing's College LondonRan2018 to 2021Enrolled86ConditionsMajor Depressive DisorderArmsComputerised decision support algorithm
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
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

9 authors.

Phillippa HarrisonCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.ORCID 0000-0002-5039-7822
Ewan CarrDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-1146-4922
Kimberley GoldsmithDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Allan YoungCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
Mark AshworthDepartment of Population Health Sciences, King's College London, London, UK.ORCID 0000-0001-6514-9904
Diede FennemaCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
Suqian DuanCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
Barbara M BarrettDepartment of Health Services & Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Roland ZahnCentre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK Roland.zahn@kcl.ac.uk.ORCID 0000-0002-8447-1453

Funding

Medical Research Council 2064430Wellcome Trust
6 · The paper itself

Abstract

objectivesTo develop and probe the first computerised decision-support tool to provide antidepressant treatment guidance to general practitioners (GPs) in UK primary care.

designA parallel group, cluster-randomised controlled feasibility trial, where individual participants were blind to treatment allocation.

settingSouth London NHS GP practices.

participantsTen practices and eighteen patients with treatment-resistant current major depressive disorder.

interventionsPractices were randomised to two treatment arms: (a) treatment-as-usual, (b) computerised decision support tool.

resultsTen GP practices participated in the trial, which was within our target range (8-20). However, practice and patient recruitment were slower than anticipated and only 18 of 86 intended patients were recruited. This was due to fewer than expected patients being eligible for the study, as well as disruption resulting from the COVID-19 pandemic. Only one patient was lost to follow-up. There were no serious or medically important adverse events during the trial. GPs in the decision tool arm indicated moderate support for the tool. A minority of patients fully engaged with the mobile app-based tracking of symptoms, medication adherence and side effects.

conclusionsOverall, feasibility was not shown in the current study and the following modifications would be needed to attempt to overcome the limitations found: (a) inclusion of patients who have only tried one Selective Serotonin Reuptake Inhibitor, rather than two, to improve recruitment and pragmatic relevance of the study; (b) approaching community pharmacists to implement tool recommendations rather than GPs; (c) further funding to directly interface between the decision support tool and self-reported symptom app; (d) increasing the geographic reach by not requiring detailed diagnostic assessments and replacing this with supported remote self-report. TRIAL REGISTRATION NUMBER: NCT03628027.

Indexed as

COVID-19Major Depressive DisorderAntidepressive AgentsDepressionFeasibility StudiesHumansLondonPandemicsPrimary Health CareAntidepressive AgentsCLINICAL PHARMACOLOGYDepression & mood disordersPRIMARY CARE

Identifiers

PMID36868594
PMCPMC9990646

What OpenQuestion holds

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Registered trials

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.