PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols
Rev Psiquiatr Salud Ment (Engl Ed). 2021 Apr 29:S1888-9891(21)00051-3.
doi: 10.1016/j.rpsm.2021.04.003.
Online ahead of print.
[Article in
English,
Spanish]
Authors
Gerard Anmella
1
, Mireia Primé-Tous
2
, Xavier Segú
2
, Aleix Solanes
3
, Victoria Ruíz
2
, Inés Martín-Villalba
2
, Ivette Morilla
4
, Antonieta Also-Fontanet
5
, Elisenda Sant
5
, Sandra Murgui
6
, Mireia Sans-Corrales
6
, Andrea Murru
1
, Roland Zahn
7
, Allan H Young
7
, Victor Vicens
8
, Clara Viñas-Bardolet
9
, Juan Francisco Martínez-Cerdá
9
, Jordi Blanch
10
, Joaquim Radua
11
, Miquel-Àngel Fullana
12
, Myriam Cavero
13
, Eduard Vieta
1
, Diego Hidalgo-Mazzei
14
Affiliations
- 1 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain.
- 2 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain.
- 3 Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- 4 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain.
- 5 CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain.
- 6 CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain.
- 7 Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
- 8 Chief Medical Officer and co-founder of Abi Global Health, Spain.
- 9 Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain.
- 10 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Chief Medical Officer and co-founder of Abi Global Health, Spain; Director of the Mental Health and Addiction Programme, Department of Health, Generalitat de Catalunya, Spain; President of the European Association of Psychosomatic Medicine, Spain.
- 11 Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- 12 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Imaging of Mood- and Anxiety-Related Disorders (IMARD) group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- 13 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain.
- 14 Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain; Digital Innovation Group, Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain; University of Barcelona, Barcelona, Catalonia, Spain; Mental Health Research Networking Center (CIBERSAM), Madrid, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. Electronic address: dahidalg@clinic.cat.
Abstract
Background:
About 30-50% of Primary Care (PC) users in Spain suffer mental health problems, mostly mild to moderate anxious and depressive symptoms, which account for 2% of Spain's total Gross domestic product and 50% of the costs associated to all mental disorders. Mobile health tools have demonstrated to cost-effectively reduce anxious and depressive symptoms while machine learning (ML) techniques have shown to accurately detect severe cases. The main aim of this project is to develop a comprehensive ML digital support platform (PRESTO) to cost-effectively screen, assess, triage, and provide personalized treatments for anxious and depressive symptoms in PC.
Methods:
The project will be carried out in 3 complementary phases: First, a ML predictive severity model will be built based on all the cases referred to the PC mental health support programme during the last 5 years in Catalonia. Simultaneously, a smartphone app to monitor and deliver psychological interventions for anxiety and depressive symptoms will be developed and tested in a clinical trial. Finally, the ML models and the app will be integrated in a comprehensive decision-support platform (PRESTO) which will triage and assign to each patient a specific intervention based on individual personal and clinical characteristics. The effectiveness of PRESTO to reduce waiting times in receiving mental healthcare will be tested in a stepped-wedge cluster randomized controlled trial in 5 PC centres.
Discussion:
PRESTO will offer timely and personalized cost-effective mental health treatment to people with mild to moderate anxious and depressive symptoms. This will result in a reduction of the burden of mental health problems in PC and on society as a whole.
Trial registration:
The project and their clinical trials were registered in Clinical Trials.gov: NCT04559360 (September 2020).
Keywords:
Aplicación para teléfonos inteligentes; Atención primaria; Machine learning; Mental health; Primary care; Salud mental; Smartphone app; mHealth.
Copyright © 2021 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.
Associated data
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ClinicalTrials.gov/NCT04559360