NCT05140551

Brief Summary

The investigators want to understand the feasibility and acceptability of implementing COMPASS: Online Cognitive behavioural therapy (CBT) in routine NHS care for individuals with diabetes. People with type 1 or type 2 diabetes with co-morbid psychological distress will be invited to take part in a pre-post implementation study of COMPASS: Online CBT for managing depression and anxiety in context of Long-Term conditions (LTCs). Patients with diabetes who are also experiencing depression and/or anxiety and/or diabetes specific distress will be recruited from: Improving Access to Psychological therapies (IAPT) services or clinics within Guys and St Thomas National Health Service (NHS) trust (GSTT) in London, United Kingdom (UK).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
12

participants targeted

Target at below P25 for not_applicable diabetes-mellitus

Timeline
Completed

Started Apr 2022

Geographic Reach
1 country

4 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 9, 2021

Completed
22 days until next milestone

First Posted

Study publicly available on registry

December 1, 2021

Completed
4 months until next milestone

Study Start

First participant enrolled

April 6, 2022

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2023

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2023

Completed
Last Updated

October 27, 2023

Status Verified

November 1, 2021

Enrollment Period

1.1 years

First QC Date

November 9, 2021

Last Update Submit

October 25, 2023

Conditions

Outcome Measures

Primary Outcomes (14)

  • To assess the socio-demographic and clinical reach of COMPASS.

    Descriptive data, specifically frequencies documenting the number of individuals who are willing to use COMPASS, reasons documented for ineligibility/non-uptake and the sociodemographic and clinical profile of users vs non-users of COMPASS.

    To be collected throughout the study duration (the study will run for an average of 12 months).

  • To assess the socio-demographic and clinical reach of COMPASS.

    Descriptive data on the types of treatment individuals with diabetes received throughout the study.

    To be collected throughout the study duration (the study will run for an average of 12 months).

  • To assess the socio-demographic and clinical reach of COMPASS.

    Descriptive data documenting the number of individuals who consent to be contacted about research and subsequently give informed consent. The investigators will also report reasons for non-consent where this is disclosed.

    To be collected throughout the study duration (the study will run for an average of 12 months).

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported mental health outcomes (listed below).

    \- General psychological distress: Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported mental health outcomes (listed below).

    \- Depression: Patient health Questionnaire -9 (PHQ-9).

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported mental health outcomes (listed below).

    \- Anxiety: Generalised anxiety disorder assessment-7 (GAD-7)

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported mental health outcomes (listed below).

    \- Diabetes distress: Diabetes distress scale -17 (DDS-17)

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported psychosocial outcomes (listed below).

    \- Loneliness: The revised University of California Los Angeles Loneliness scale (UCLA-R)

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported psychosocial outcomes (listed below).

    \- Social Functioning: The Work and Social Adjustment Scale (WSAS)

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported psychosocial outcomes (listed below).

    \- Health Related Quality of Life: The European Quality of Life scale (EQ-5D-3L)

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To explore the potential efficacy of COMPASS by examining pre-post change scores on self-reported physical health outcomes (listed below).

    \- Glycaemic control: self-reported HbA1c levels.

    To be collected at baseline, 12 weeks and 6 month follow up.

  • To examine barriers and facilitators to the adoption of COMPASS from the perspective of both staff and patients.

    Semi-structured interviews will be conducted to explore patient and health care professional (HCP) perceptions of the barriers and facilitators of using COMPASS in the context of diabetes.

    To be collected at 12 weeks.

  • To examine: i) number of patients who require digital support to use COMPASS ii) monthly referrals to COMPASS by staff.

    The investigators will use descriptive statistics to quantify the number of patients who require digital support to use COMPASS and ii) monthly referrals to COMPASS by staff.

    To be collected at 12 weeks.

  • To assess the implementation of COMPASS in terms of patient adherence to COMPASS online sessions and number and duration of therapist support calls attended.

    Descriptive data on number of online sessions completed and number and duration of therapist support calls attended will be extracted from the COMPASS program.

    To be collected throughout the study duration (the study will run for an average of 12 months).

Study Arms (1)

COMPASS

EXPERIMENTAL

This is a single arm study. We are investigating COMPASS digital CBT.

Device: COMPASS: digital CBT

Interventions

COMPASS is an evidence based digital CBT intervention with guided therapist support, tailored to treat anxiety and/or depression in long term conditions (LTCs). The intervention consists of eleven modules/sessions in which CBT techniques are taught. Users of COMPASS receive guided therapist support from a trained therapist. The guided support aims to help patients identify and apply the CBT skills outlined in COMPASS to meet their individual needs and experiences of living with LTC(s). The support can occur through in-site messaging or via the telephone.

Also known as: COMPASS: Navigating your long-term condition
COMPASS

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may not qualify if:

  • Currently in receipt of psychological treatment for anxiety and/or depression.
  • Evidence of a severe mental health disorder (including bipolar disorder or psychosis) and/or alcohol and/or drug dependency identified by highly trained IAPT therapists as part of routine care.
  • Acute suicidal risk requiring a level of support that cannot be provided by therapists who are supporting patients remotely in their use of digital health interventions.
  • GSTT (secondary care recruitment)
  • \- Evidence of a diabetes related eating disorder requiring a level of support that cannot be provided by therapists who are supporting patients remotely in their use of digital health interventions evidenced through a DEPS-R score of ≥20.
  • Eligibility criteria for the qualitative study - Qualitative Patient and healthcare professionals (HCP) interviews:
  • The investigators will interview participants who have experience of receiving COMPASS and those who do not uptake COMPASS.
  • The investigators also aim to interview participants who commenced COMPASS and subsequently dropped out of treatment.
  • The investigators will interview HCPs who have assessed and triaged patients for treatment, and those who have provided psychological support to individuals with diabetes.
  • Patients and HCPs will be purposively sampled to achieve a mix of age, gender, ethnicity, clinical variables and/or professional experience.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Guys Hospital

London, Other, CV31 2QE, United Kingdom

Location

Emma Jenkinson

London, N19 4TA, United Kingdom

Location

King's College London

London, SE1 9RT, United Kingdom

Location

South London and Maudsley

London, United Kingdom

Location

MeSH Terms

Conditions

Diabetes MellitusDiabetes Mellitus, Type 2Diabetes Mellitus, Type 1DepressionAnxiety DisordersSocial Adjustment

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System DiseasesBehavioral SymptomsBehaviorMental DisordersSocial Behavior

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 9, 2021

First Posted

December 1, 2021

Study Start

April 6, 2022

Primary Completion

May 1, 2023

Study Completion

July 1, 2023

Last Updated

October 27, 2023

Record last verified: 2021-11

Data Sharing

IPD Sharing
Will not share

Locations