CASPER plus (CollAborative care in Screen-Positive EldeRs with major depressive disorder): study protocol for a...

Area of Science:

• Gerontology
• Psychiatry
• Public Health

Background:

• Depression is a significant global health burden, particularly affecting older adults (65+ years).
• Late-life depression is underdiagnosed and undertreated in primary care, leading to chronic illness and disability.
• Current management often relies on antidepressants with poor adherence, neglecting psychosocial interventions.

Purpose of the Study:

• To evaluate the clinical and cost-effectiveness of a collaborative care intervention for moderate to severe depression in individuals aged 65 years and over.
• To assess the impact of collaborative care on depression severity and health-related quality of life in older adults.
• To explore the acceptability, implementation, and sustainability of collaborative care in primary care settings.

Main Methods:

• A multi-centre, randomised controlled trial (CASPER Plus) involving 450 participants aged 65+ with major depressive disorder.
• Intervention group received collaborative care (behavioral activation and medication management) over 8-10 weeks, alongside usual GP care.
• Control group received usual GP care alone. Depression severity (PHQ-9) and quality of life (SF-12, EQ-5D) were measured at baseline and 4, 12, 18 months.

Main Results:

• The study aims to add to existing evidence on depression management in older adults.
• A positive outcome could lead to the commissioning of this collaborative care model in primary care services.
• Results will inform strategies for identifying and managing depression in an ageing population.

Conclusions:

• Collaborative care interventions show promise for improving outcomes in older adults with depression.
• This model may offer a more effective and sustainable approach to managing late-life depression in primary care.
• Further research and implementation are warranted to address the significant burden of depression in the elderly.