Stepped-care to prevent depression and anxiety in visually impaired older adults – design of a randomised controlled trial

BMC Psychiatry

Study Protocol

Judith E Bosmans¹  Ruth MA van Nispen²  Hilde PA van der Aa²  Ger HMB van Rens³  Hannie C Comijs⁴  Tom H Margrain⁵ 

[1]Department of Health Sciences and EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands

[2]Department of Ophthalmology, VU University Medical Centre, P.O. Box 7057, 1007, Amsterdam, MB, The Netherlands

[3]EMGO Institute for Health and Care Research (EMGO+), VU University Medical Centre, Van der Boechorststraat 7, 1081, Amsterdam, BT, The Netherlands

[4]Department of Ophthalmology, VU University Medical Centre, P.O. Box 7057, 1007, Amsterdam, MB, The Netherlands

[5]EMGO Institute for Health and Care Research (EMGO+), VU University Medical Centre, Van der Boechorststraat 7, 1081, Amsterdam, BT, The Netherlands

[6]Department of Ophthalmology, Elkerliek Hospital, Wesselmanlaan 25, 5707, Helmond, HA, The Netherlands

[7]EMGO Institute for Health and Care Research (EMGO+), VU University Medical Centre, Van der Boechorststraat 7, 1081, Amsterdam, BT, The Netherlands

[8]Department Psychiatry VUmc/ GGZinGeest, A.J.Ernststraat 1187, 1081, Amsterdam, HL, The Netherlands

[9]School of Optometry and Vision Sciences, Cardiff University, CF24, 4LU, Cardiff, United Kingdom

关键词: Low vision;    Stepped-care;    Older adults;    Depression;    Anxiety;    Prevention;   

DOI  :  10.1186/1471-244X-13-209

 received in 2013-07-15, accepted in 2013-08-07,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundSubthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group.Method/designA stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in the Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI).DiscussionPreventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step.Trial registrationIdentifier: NTR3296

【 授权许可】

CC BY   
© van der Aa et al.; licensee BioMed Central Ltd. 2013