Research blog: PROMPT project reveals complex profile of people using psychological therapy services

Dr Nilay Hepgul is a researcher at the NIHR Maudsley Biomedical Research Centre and King’s College London Cicely Saunders Institute.  Her work covers clinical and biological psychiatry, and predictors of patient health outcomes, and she is currently the Trial Manager for the OPTCARE Neuro project.  Here, she tells us about her work on the PROMPT project, which was recently published in the scientific journal BMC Psychiatry.

Improving Access to Psychological Therapies (IAPT) is a national programme which offers routine and rapid access to psychological therapies – such as cognitive behaviour therapy and other “talking therapies” – for people with depression and anxiety disorders. 

One of the ways we can monitor and improve services like this is to collect and analyse information about the people who use the service, and whether their treatment is successful.  For this reason, my colleagues and I started a research project called "Predicting outcome following psychological therapy in IAPT (PROMPT)".

Between February 2014 and February 2015 we recruited just under 150 patients awaiting treatment within an IAPT service in our local area, a diverse part of urban London.  The project is still ongoing, but our recent report published in the journal BMC Psychiatry describes in detail the profile of the people who we recruited in the first year of the project.

What we found is that the characteristics of people using the IAPT service were generally very complicated – for example, whilst most people are referred to the service for depression and / or anxiety, in many cases they also have other psychiatric illnesses, such as personality disorder and bipolar disorder, and around two thirds of the patients reported experiencing at least one traumatic event in childhood, such as abuse, or parental neglect.

These findings could have significant implications for the people using these services, in terms of the therapy they receive, and whether their treatment is successful.  The fact that many people in our study have more than one psychiatric illness means we’d expect treatment outcomes to be affected in a number of ways, including increased drop-out rates from treatments, and potentially lower success rates for treatment in general. 

It’s likely that many people presenting to IAPT services may have significant needs over and above those met by the relatively brief interventions that IAPT services are currently expected and are equipped to provide.

However, our ongoing work with the PROMPT project aims to identify characteristics which could predict whether or not treatment is likely to be successful for people seen within an IAPT service.  Hopefully, this will enable future clinical decision making to be based on the needs of the individual in an evidence-based manner. Furthermore, identifying why some people don’t improve following therapy delivered by IAPT services could be used to develop new types of treatment.

The PROMPT project is the first time both clinical and biological information has been systematically collected from people using an IAPT service.  Usually research is based only on routine clinical information, which can only give a limited picture of the individual and their response to treatment.   

In addition to our ongoing work into how we can predict whether people will respond to treatment, our study also shows for the first time that research like this – with a complex, urban population accessing a first-line rapid treatment service like IAPT – is possible.  We hope that other researchers will also be able to use these methods to provide further insights into how we can improve treatments for people using these services.

Tags: Publications - Novel Therapeutics -

By NIHR Maudsley BRC at 16 Mar 2016, 11:14 AM

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