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Trial registered on ANZCTR
Registration number
ACTRN12621000894897p
Ethics application status
Submitted, not yet approved
Date submitted
21/05/2021
Date registered
8/07/2021
Date last updated
8/07/2021
Date data sharing statement initially provided
8/07/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Community-based Intensive Activation Therapy for Major Depression
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Scientific title
Feasibility and Efficacy of Community-based Intensive Activation Therapy for Major Depression
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Secondary ID [1]
304277
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Nil
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Universal Trial Number (UTN)
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Trial acronym
Nil
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Linked study record
Nil
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Health condition
Health condition(s) or problem(s) studied:
Depression
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Condition category
Condition code
Mental Health
319725
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This study is evaluating the feasibility of delivering therapy to people currently being treated for Major Depressive Disorder by their general practitioners. They will be randomised to receive either Intensive Activation Therapy or Patient-centred Psychoeducation – a supportive educational therapy. Intensive Activation Therapy is a combination of Behavioural Activation and Cognitive Remediation which has been designed for this study. Sessions will be delivered in person or via videoconference and will be delivered twice a week for four weeks and then weekly for another four weeks, with some flexibility in timing (allowing a total therapy time of 10 weeks). Sessions last between 30 and 40 minutes. The intervention is delivered by nurses and psychologists. Fidelity to treatment model will be monitored by the supervising psychologist with regular supervision sessions. Therapy tracking forms will contain date, session number, level of engagement, therapy focus and duration of session.
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Intervention code [1]
320616
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Behaviour
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Intervention code [2]
320924
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Treatment: Other
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Comparator / control treatment
Patient-centred Psychoeducation (PDP) is a supportive educational control therapy. It will be delivered one-to-one either in-person or via teleconferencing platform. It is a manualised therapy designed for use in a previous feasibility study. It involves supportive therapy and education about triggers, early warning signs and management strategies. Patients will receive 5 sessions of 30-40 minutes over 8 weeks of PDP. PDP uses online and hard copy psychoeducational resources combined with 5 psychoeducational sessions with a therapist. The education resources have been designed for this study. The intervention is delivered by nurses and psychologists. Fidelity to treatment model will be monitored by the supervising psychologist with regular supervision sessions. Therapy tracking forms will contain date, session number, level of engagement, therapy focus and duration of session.
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Control group
Active
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Outcomes
Primary outcome [1]
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Ability to recruit 40 participants and deliver therapy over 2 years.
This will be assessed using an audit of the study database and therapy tracking forms.
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Assessment method [1]
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Timepoint [1]
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24 months from commencement of recruitment process.
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Primary outcome [2]
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Acceptability of the process of recruitment, assessment and therapy to Maori and non-MaoriData will be collected on the numbers who engage in >75% of sessions, those that drop out and the reasons for drop out. Data will be collected on participant preferences for in-person or tele-conference delivery and reasons. Qualitative interviews will be conducted with all participants on completion of the intervention to evaluate their perceptions of effectiveness, accessibility of the intervention, and its general acceptability as an intervention.
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Assessment method [2]
328199
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Timepoint [2]
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24 months
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Primary outcome [3]
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Completion of adequate dose of therapy
Number of, and content of therapy sessions will be recorded and doses of therapy calculated from this.
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Assessment method [3]
328200
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Timepoint [3]
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24 months
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Secondary outcome [1]
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Depressive symptoms measured using Quick Inventory of Depressive Symptoms - Self-Report.
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Assessment method [1]
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Timepoint [1]
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8 weeks from commencement of intervention.
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Secondary outcome [2]
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Ability to manage risk in a community setting
Brief risk assessments will be conducted in each session and crisis plans developed with each patient, including directions regarding contacting family or doctors. Therapists may also recommend that patients seek a medication review with their GP if this is deemed necessary. At recruitment, patients will provide details of contacts for GPs and/or private psychiatrists and a letter from the medical practitioner acknowledging that the patient is participating in the study but that they will continue to provide usual care. The feasibility study will assess the practicality of these arrangements and their acceptability for primary care clinicians.
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Assessment method [2]
397997
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Timepoint [2]
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24 months
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Secondary outcome [3]
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Training of therapists and ability to maintain treatment fidelity. Intervention and control treatments will be delivered according to a manualised protocol. Some sessions will be recorded to assess the degree to which the therapist employs techniques appropriate to both interventions.
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Assessment method [3]
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Timepoint [3]
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24 months
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Eligibility
Key inclusion criteria
Primary diagnosis of major depressive episode
Under GP care
Able to participate in weekly sessions in person or via zoom
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(i) Major Depressive Disorder. (MDD) not the primary diagnosis, (ii) unable to provide informed consent, (iii) unable to participate in a 8-10-week psychotherapy (iii) cognitive impairment from organic causes. Patients in remote centres will only be able to participate if they have a computer and workable internet access
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients will receive sealed opaque envelopes with their randomisation allocation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated randomisation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
No statistical methods in feasibility study
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
4/10/2021
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Actual
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Date of last participant enrolment
Anticipated
29/07/2023
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Actual
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Date of last data collection
Anticipated
29/07/2023
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Canterbury
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NZ Health Research Council
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Address [1]
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PO Box 5541, Victoria Street West, Auckland 1142
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
UNiversity of Otago
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Address
PO Box 4345 Christchurch NZ 8011
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
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Nil
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Country [1]
309531
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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NZ Health and Disability Ethics Committee-Expedited Review pathway.
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Ethics committee address [1]
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PO Box 5013, Wellington 6140
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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21/05/2021
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Approval date [1]
308580
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Ethics approval number [1]
308580
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Summary
Brief summary
People with mood disorders, such as major depressive disorder, often have problems with functioning in everyday life because of a lack of energy and the ability to get started on activities. We have successfully delivered Intensive Activation Therapy in an inpatient setting and want to make it available in the community. We can deliver the therapy in person or via teleconferencing such as Zoom. This study is evaluating the feasibility of delivering the therapy to people currently being treated for Major Depressive Disorder by their GPs. They will be randomised to receive either Intensive Activation Therapy or Patient-centred Psychoeducation – a supportive educational therapy.
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Trial website
N/A
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Trial related presentations / publications
N/A
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Public notes
N/A
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Contacts
Principal investigator
Name
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Prof Marie Crowe
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Address
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Dept of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch
NZ 8011
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Country
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New Zealand
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Phone
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+64 3 3726700
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Marie Crowe
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Address
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Dept of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch
NZ 8011
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Country
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New Zealand
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Phone
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+64 3 3726700
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Marie Crowe
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Address
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Dept of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch
NZ 8011
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Country
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New Zealand
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Phone
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+64 3 3726700
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Fax
111216
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This is a feasibility study
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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