Impact of psychological therapies on emergency medical admissions
Research type
Research Study
Full title
A feasibility study of the transferability of Improving Access to Psychological Therapies (IAPT) to a general hospital emergency inpatient ward.
IRAS ID
301933
Contact name
Rebecca Pulford
Contact email
Sponsor organisation
East Suffolk and North East Essex NHS Foundation Trust
Clinicaltrials.gov Identifier
TBC , Upon HRA/REC approval, registered by ESNEFT R+D on ClinicalTrials.gov
Duration of Study in the UK
0 years, 9 months, 29 days
Research summary
Summary of Research
This study will take place in a general hospital, specifically people who come in with a medical emergency. Patients come in as an emergency because they have something physical going on and we assess and treat that.
We know from research that one in six adults suffer from depression or anxiety (Layard and Clark, 2015). Psychological therapies (Talking therapies) has made considerable progress in developing treatments for anxiety and depression with good recovery results, this has been recognised by the National Institute for health and care excellence (NICE). This treatment for people is available and delivered in a community setting, people can self-refer or be referred. The NHS has set a side funding to expanding this treatment in the form of ‘Improving access to Psychological treatment’ (IAPT).
Whilst we know how many people suffer in the community population we do not know how many people in our medical emergency group of patients are suffering with Anxiety or depression, we do not routinely assess and we do not routinely treat or provide tools to help their anxiety and depression while they are coping with the reason they came into hospital. We do not know if their anxiety or depression causes them to stay in hospital longer or be readmitted to hospital in contrast to those who are not clinically depressed or anxious.
This study will look to see how many patients are clinically depressed or anxious. The study aims to assess the feasibility of conducting a definitive IAPT trial in the emergency setting, in terms of recruitment, use and acceptability of the IAPT intervention by patients and staff. Findings of this feasibility study will inform future studies.Summary of Results
Previous literature has reported that patients who are admitted to hospital with an acute medical presentation and comorbidity of depression stayed 2.45 days longer in hospital than patients who did not have depression. Emergency admissions in English hospitals are increasing, impacting on bed capacity and safe delivery of care so identifying and providing interventions to reduce depression may be important in reducing the length of stay in hospital.
Depression and anxiety assessments are not consistently conducted as part of the emergency admissions process and as such the prevalence of depression and anxiety is unknown within the acute medical population. In addition, psychological intervention is not routinely provided in medical wards.
The feasibility of:
a) Collecting data on common mental health conditions on admission.
b) Implementation of Improving Access to Psychological Therapy within an acute medical ward.
C) Collecting length of stay and readmission rates and linking to outcome measures was conducted to inform a multi-centred random control trial.
The study adopted Orsmond and Cohen (2015) feasibility study framework. A mixed methods approach was used.
The sample included all patients admitted to medical wards under study. Quantitative data was collected on the sample, recruitment demographics, Length of Stay and Readmission data. Patients who received intervention completed a structured questionnaire on discharge. A series of staff focus groups tested the feasibility of intervention.
The study concluded that it is feasible to collect data on anxiety and depression prevalence. 26.84% of the acute medical admission population displayed signs of anxiety or depression. Patients who received intervention reported that it was acceptable to receive psychological treatment at the bedside. Staff supported the intervention, however nurses struggled to complete the initial screening tool.
This study provides new evidence into the prevalence of common mental health conditions in the acute medical pathway. It demonstrates the feasibility of delivering psychological care at the bedside.REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
21/EE/0206
Date of REC Opinion
5 Oct 2021
REC opinion
Further Information Favourable Opinion