Condition category
Mental and Behavioural Disorders
Date applied
04/04/2018
Date assigned
06/04/2018
Last edited
06/04/2018
Prospective/Retrospective
Retrospectively registered
Overall trial status
Ongoing
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims:
Of the 1.4 million people referred to the NHS Improving Access to Psychological Therapies (IAPT) service in 2015/16, almost two in three people did not complete their course of treatment. The service currently experiences a relatively high rate of missed appointments (roughly 11%). This imposes a cost on the services and increases waiting times for others. The aim of this study is to test whether sending a series of text messages to patients awaiting IAPT treatment can reduce unscheduled dropout. The study measures whether patients who receive the text messages while waiting are more likely to attend two or more IAPT appointments than those who do not. In addition to this, the study tests whether the text messages can reduce unscheduled dropout, increase completion of treatment and ultimately improve health outcomes (depression and anxiety).

Who can participate?
Adult patients of one of the seven participating IAPT services who are referred to the service during the study period

What does the study involve?
Participants are randomly allocated to either receive a series of additional text messages while they are on the IAPT waiting list (the intervention), or to continue to receive standard communication from services (business as usual). The intervention involves sending patients a series of up to nine text messages based on the concept of operational transparency. Operational transparency is the idea of de-shrouding a process so that people know what is happening behind the scenes and know that they are progressing. The study assesses whether or not operational transparency increases engagement with the IAPT waiting process. The number of text messages a patient receives depends on how long they are held on waiting lists.

What are the possible benefits and risks of participating?
The intervention aims to increase the likelihood that patients engage with the IAPT service and attend their appointments. Attending an appointment should increase the likelihood that the patient recovers and also help them recover sooner. The main risk is that the new messages have a backfire effect and increase missed appointments or dropout from the service. The messages have been carefully worded to guard against this happening.

Where is the study run from?
1. Talking Changes (Tees, Esk and Wear Valleys NHS Foundation Trust)
2. Talking Therapies (Somerset Partnership NHS Foundation Trust)
3. Talking Matters Northumberland
4. Mersey Care - Talk Liverpool (Mersey Care NHS Foundation Trust)
5. Talk Wandsworth (South West London & St George’s NHS Mental Health Trust)
6. Sutton Uplift (South West London & St George’s NHS Mental Health Trust)
7. Outlook South West

When is the study starting and how long is it expected to run for?
September 2017 to December 2018

Who is the main contact?
Victoria Fussey

Trial website

Contact information

Type

Scientific

Primary contact

Ms Victoria Fussey

ORCID ID

Contact details

Behavioural Insights Team
4 Matthew Parker Street
London
SW1H 9NP
United Kingdom

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

37752

Study information

Scientific title

A randomised controlled trial to measure the impact of operational transparency text messages during waiting periods on attendance and engagement with treatment among Improving Access to Psychological Therapies (IAPT) patients

Acronym

Study hypothesis

Improving Access to Psychological Therapies (IAPT) services provide treatment to people with anxiety and depression. The IAPT programme began in 2008 and has successfully increased access to psychological therapy for many people, but there is room for improvement in the service. Of the 1.4 million people referred to the service in 2015/16, almost two in three people did not complete a course of treatment. This imposes a cost on the services and increases waiting times for others. This study will test whether sending a series of text messages to patients awaiting IAPT treatment can reduce unscheduled dropout.

Ethics approval

Yorkshire & The Humber - Bradford Leeds Research Ethics Committee, 28/03/2018, ref: 18/YH/0105

Study design

Randomised; Interventional; Design type: Process of Care, Other

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

GP practices

Trial type

Quality of life

Patient information sheet

Not available in web format, please use the contact details to request a patient information sheet

Condition

Specialty: Mental health, Primary sub-specialty: Study not assigned to a MH Clinical Studies Group; UKCRC code/ Disease: Mental Health/ Unspecified mental disorder

Intervention

At the point of referral into a participating IAPT service eligible patients will be allocated at random through a statistical randomisation procedure implemented by Mayden. Patients will be allocated with equal probability either to receive the series of text messages (the intervention), or to continue to receive standard communication from services (business as usual).

The intervention that will be tested in this trial will be a series of text messages sent to patients on IAPT waiting lists. The text messages will be based on the idea of operational transparency, and will provide regular contact from the IAPT service to the patient letting the patient know the effort that is being exerted behind the scenes.

The trialists will measure whether patients who received the text messages while waiting were more likely to attend two or more IAPT appointments than those who did not. They will also look at unscheduled dropout, completion of treatment and health outcomes (depression and anxiety) as secondary outcome measures.

Intervention type

Behavioural

Phase

Drug names

Primary outcome measure

Whether a patient completes 2 or more appointments, routinely collected by the IAPT service and uploaded to Mayden the iaptus service provider, collected at the end of the trial

Secondary outcome measures

1. Patient has unscheduled dropout from treatment, routinely collected by the IAPT service and uploaded to Mayden the iaptus service provider, collected at the end of the trial
2. Patient completes treatment, routinely collected by the IAPT service and uploaded to Mayden the iaptus service provider, collected at the end of the trial
3. Mental health outcomes (anxiety and depression), assessed using the PHQ-9 and/or the GAD-7 at the first and the last appointment

Overall trial start date

01/09/2017

Overall trial end date

01/12/2018

Reason abandoned (if study stopped)

Eligibility

Participant inclusion criteria

1. Patient has been referred to a participating IAPT service during the recruitment period of the trial period
2. Patient has consented to receive SMS communication from their IAPT service
3. Patient has supplied a valid mobile phone number to their IAPT service

Participant type

Patient

Age group

Adult

Gender

Both

Target number of participants

Planned Sample Size: 15000; UK Sample Size: 15000

Participant exclusion criteria

Does not meet the inclusion criteria

Recruitment start date

01/04/2018

Recruitment end date

01/07/2018

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Talking Changes
Tees, Esk and Wear Valleys NHS Foundation Trust Tarncroft Lanchester Rd Hospital
Durham
DH1 5RD

Trial participating centre

Talking Therapies
Somerset Partnership NHS Foundation Trust Mallard Court Express Park Bristol Road
Bridgwater
TA6 4RN

Trial participating centre

Talking Matters Northumberland
Unit 4, Telford Court Morpeth
Northumberland
NE61 2DB

Trial participating centre

Mersey Care - Talk Liverpool
Mersey Care NHS Foundation Trust 151 Dale Street
Liverpool
L2 2AH

Trial participating centre

Talk Wandsworth
South West London & St George’s NHS Mental Health Trust Springfield University Hospital, 15, 61 Glenburnie Rd
London
SW17 7DJ

Trial participating centre

Sutton Uplift
South West London & St George’s NHS Mental Health Trust Springfield University Hospital, 15, 61 Glenburnie Rd
London
SW17 7DJ

Trial participating centre

Outlook South West
2D Restormel Estate
Lostwithiel
PL22 0HG

Sponsor information

Organisation

Behavioural Insights Limited

Sponsor details

Behavioural Insights Team
4 Matthew Parker Street
London
SW1H 9NP
United Kingdom

Sponsor type

Other

Website

Funders

Funder type

Government

Funder name

Cabinet Office, UK Government; Grant Codes: RM-BIT/1

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Exact future plans for publication are not finalised, but the trialists intend to report and disseminate the results of the study through an internal report on the Behavioural Insights Team website, through conference presentation and in a peer-reviewed scientific journal.

IPD sharing statement
The datasets generated during and/or analysed during the current study are not expected to be made available as data sharing agreements with the participating organisations states that the data will only be used for analysis of the trial and that it will not be shared publicly.

Intention to publish date

01/12/2019

Participant level data

Not expected to be available

Basic results (scientific)

Publication list

Publication citations

Additional files

Editorial Notes