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Anmella G, Primé-Tous M, Segú X, Solanes A, Ruíz V, Martín-Villalba I, Morilla I, Also-Fontanet A, Sant E, Murgui S, Sans-Corrales M, Murru A, Zahn R, Young AH, Vicens V, Viñas-Bardolet C, Martínez-Cerdá JF, Blanch J, Radua J, Fullana MÀ, Cavero M, Vieta E, Hidalgo-Mazzei D. PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols. Span J Psychiatry Ment Health 2024; 17:114-125. [PMID: 33933665 DOI: 10.1016/j.rpsm.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/22/2021] [Accepted: 04/19/2021] [Indexed: 12/24/2022]
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).
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Affiliation(s)
- Gerard Anmella
- 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
| | - Mireia Primé-Tous
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Xavier Segú
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Aleix Solanes
- 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
| | - Victoria Ruíz
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Inés Martín-Villalba
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, 170 Villarroel st, 12-0, 08036 Barcelona, Catalonia, Spain
| | - Ivette Morilla
- 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
| | - Antonieta Also-Fontanet
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Elisenda Sant
- CAP Casanova, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Sandra Murgui
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Mireia Sans-Corrales
- CAP Borrell, Consorci d'Atenció Primaria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Catalonia, Spain
| | - Andrea Murru
- 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
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Victor Vicens
- Chief Medical Officer and co-founder of Abi Global Health, Spain
| | - Clara Viñas-Bardolet
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Juan Francisco Martínez-Cerdá
- Data Analytics Programme for Health Research and Innovation (PADRIS) from the Catalan Agency for Health Quality and Evaluation (AQuAS), Catalonia, Spain
| | - Jordi Blanch
- 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
| | - Joaquim Radua
- 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
| | - Miquel-Àngel Fullana
- 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
| | - Myriam Cavero
- 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
| | - Eduard Vieta
- 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
| | - Diego Hidalgo-Mazzei
- 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.
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