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Trials
Published in: Trials 1/2022

01-12-2022 | Mood Disorders | Study protocol

Collaborative community mental health and aged care services with peer support to prevent late-life depression: study protocol for a non-randomised controlled trial

Authors: Tianyin Liu, Dara Kiu Yi Leung, Shiyu Lu, Wai-Wai Kwok, Lesley Cai Yin Sze, Samson Shu Ki Tse, Siu Man Ng, Paul Wai Ching Wong, Vivian Wei Qun Lou, Jennifer Yee Man Tang, Daniel Fu Keung Wong, Wai Chi Chan, Ricky Yu Kwong Kwok, Terry Yat Sang Lum, Gloria Hoi Yan Wong

Published in: Trials | Issue 1/2022

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Abstract

Background

Late-life depression is common, modifiable, yet under-treated. Service silos and human resources shortage contribute to insufficient prevention and intervention. We describe an implementation research protocol of collaborative stepped care and peer support model that integrates community mental health and aged care services to address service fragmentation, using productive ageing and recovery principles to involve older people as peer supporters to address human resource issue.

Methods/design

This is a non-randomised controlled trial examining the effectiveness and cost-effectiveness of the “Jockey Club Holistic Support Project for Elderly Mental Wellness” (JC JoyAge) model versus care as usual (CAU) in community aged care and community mental health service units in 12 months. Older people aged 60 years and over with mild to moderate depressive symptoms or risk factors for developing depression will be included. JoyAge service users will receive group-based activities and psychoeducation, low-intensity psychotherapy, or high-intensity psychotherapy according to the stepped care protocol in addition to usual community mental health or aged care, with support from an older peer supporter. The primary clinical outcome, depressive symptoms, and secondary outcomes, self-harm risk, anxiety symptoms, and loneliness, will be measured with the Patient Health Questionnaire-9 (PHQ-9), Self-Harm Inventory, Generalized Anxiety Disorder 7-item scale (GAD-7), and UCLA Loneliness 3-item scale (UCLA-3) respectively. Cost-effectiveness analysis will assess health-related quality of life using the EQ-5D-5L and service utilisation using the Client Service Receipt Inventory (CSRI). We use multilevel linear mixed models to compare outcomes change between groups and calculate the incremental cost-effectiveness ratio in terms of quality-adjusted life years.

Discussion

This study will provide evidence about outcomes for older persons with mental health needs receiving collaborative stepped care service without silos and with trained young-old volunteers to support engagement, treatment, and transitions. Cost-effectiveness findings from this study will inform resource allocation in this under-treated population.

Trial registration

ClinicalTrials.​gov NCT03593889. Registered on 20 July 2018.
Appendix
Available only for authorised users
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Metadata
Title
Collaborative community mental health and aged care services with peer support to prevent late-life depression: study protocol for a non-randomised controlled trial
Authors
Tianyin Liu
Dara Kiu Yi Leung
Shiyu Lu
Wai-Wai Kwok
Lesley Cai Yin Sze
Samson Shu Ki Tse
Siu Man Ng
Paul Wai Ching Wong
Vivian Wei Qun Lou
Jennifer Yee Man Tang
Daniel Fu Keung Wong
Wai Chi Chan
Ricky Yu Kwong Kwok
Terry Yat Sang Lum
Gloria Hoi Yan Wong
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06122-1

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