What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the dep-gp database

TY - JOUR

T1 - What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the dep-gp database

AU - Buckman, Joshua E.J.

AU - Saunders, Rob

AU - Cohen, Zachary D.

AU - Clarke, Katherine

AU - Ambler, Gareth

AU - Derubeis, Robert J.

AU - Gilbody, Simon

AU - Hollon, Steven D.

AU - Kendrick, Tony

AU - Watkins, Edward

AU - White, Ian R.

AU - Lewis, Glyn

AU - Pilling, Stephen

N1 - Funding Information: This work was supported by the Wellcome Trust through a Clinical Research Fellowship to JEJB [201292]. SP, KC and RS were all funded by University College London through the Research Department of Clinical, Educational and Health Psychology and respectively funded by the Higher Education Funding Council for England, NIHR, and the Royal College of Psychiatrists. SP and GL, and GA were supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. ZC was supported by MQ Foundation [MQDS16/72]. RJDeR was on the faculty in the Department of Psychology at the University of Pennsylvania. SH was on the faculty in the Department of Psychology at Vanderbilt University in Nashville Tennessee USA. IW was supported by the Medical Research Council Programme [MC_UU_12023/21]. TK was funded through the University of Southampton by the Higher Education Funding Council for England. EW was funded through the University of Exeter by the Higher Education Funding Council for England. SG was funded by grants from the National Institute for Health Research. Funding Information: were all funded by University College London through the Research Department of Clinical, Educational and Health Psychology and respectively funded by the Higher Education Funding Council for England, NIHR, and the Royal College of Psychiatrists. SP and GL, and GA were supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. ZC was supported by MQ Foundation [MQDS16/72]. RJDeR was on the faculty in the Department of Psychology at the University of Pennsylvania. SH was on the faculty in the Department of Psychology at Vanderbilt University in Nashville Tennessee USA. IW was supported by the Medical Research Council Programme [MC 栀UU 栂b2023/21]. TK was funded through the University of Southampton by the Higher Education Funding Council for England. EW was funded through the University of Exeter by the Higher Education Funding Council for England. SG was funded by grants from the National Institute for Health Research. Funding Information: Grant information: This work was supported by the Wellcome Trust through a Clinical Research Fellowship to JEJB [201292]. SP, KC and RS Publisher Copyright: © 2019 Buckman JEJ et al.

PY - 2020/4/1

Y1 - 2020/4/1

N2 - Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed.

AB - Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed.

KW - Depression

KW - Individual Patient Data

KW - Meta-analysis

KW - Primary Health Care

KW - Prognosis

KW - Protocol

KW - Systematic Review

UR - http://www.scopus.com/inward/record.url?scp=85076366657&partnerID=8YFLogxK

U2 - 10.12688/wellcomeopenres.15225.3

DO - 10.12688/wellcomeopenres.15225.3

M3 - Article

AN - SCOPUS:85076366657

SN - 2398-502X

VL - 4

JO - Wellcome Open Research

JF - Wellcome Open Research

M1 - 69

ER -