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Trial registered on ANZCTR
Registration number
ACTRN12614001244695
Ethics application status
Approved
Date submitted
30/10/2014
Date registered
27/11/2014
Date last updated
22/01/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Low Intensity Intervention to Reduce Depression and Anxiety in People Exposed to Adversity
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Scientific title
Exploratory Randomised Controlled Trial of Problem Management Plus versus Enhanced Treatment as Usual to Reduce Depression and Anxiety in People Exposed to Adversity
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Secondary ID [1]
285563
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Posttraumatic Stress Disorder
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Depression
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Condition category
Condition code
Mental Health
293673
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0
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Depression
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Mental Health
293812
293812
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0
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
There are two arms to this trial. Arm 1: Problem Management Plus. Arm 2: Enhanced Treatment as Usual. Therapy is administered once-weekly over
5 weeks on an individual 90 minute basis. Problem Management Plus includes skills in identifying emotional and practical problems that can be managed and strategies to reduce and cope with these problems. The duration of the study for any participant will conclude after immediate post-trial follow-up assessment, resulting in participation duration of 1.5 months. Therapy is provided by local health workers.
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Intervention code [1]
290514
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Behaviour
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Intervention code [2]
290707
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Treatment: Other
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Comparator / control treatment
Enhanced Treatment as Usual comprises normal treatment provided by local physicians who will receive a single 2-day refresher training workshop on identification and management of mental disorders. The duration of the study for any participant will conclude after post-trial follow-up assessment, resulting in participation duration of 1.5 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Anxiety and depression are a composite outcome that are measured by mean score on the General Health Questionnaire
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Assessment method [1]
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Timepoint [1]
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Pretreatment (week 1), posttreatment (week 7)
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Secondary outcome [1]
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Mean scores on the World Health Organization Disability Assessment Schedule 2.0
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Assessment method [1]
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Timepoint [1]
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Pretreatment (week 1), posttreatment (week 7)
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Secondary outcome [2]
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Mean scores on the Posttraumatic Stress Disorder Checklist
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Assessment method [2]
311145
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Timepoint [2]
311145
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Pretreatment (week 1), posttreatment (week 7)
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Eligibility
Key inclusion criteria
GHQ >1 and WHODAS>16
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(a) Imminent suicidal intent, (b) severe mental disorder, (c) severe cognitive impairment, (d) acute protections risks (e) exposure to trauma in last month.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be adults attend primary health care centers and indicating moderate distress & impaired functioning. Participants wishing to participate will be randomly allocated according to a random numbers system administered by an individual who independent of the study and who works at a site that is distant from the treatment centre.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomized by an independent research assistant, not involved in the assessments. There is no stratification in this pilot trial. Randomisation will occur by a randomisation table created by a computerised sequence.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Since this is a small exploratory RCT (to inform a definitive RCT) that does not aim to detect statistically significant differences in effectiveness, no power calculations have been carried out. Outcome measures will comprise the GHQ, PCL, and WHODAS.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/02/2014
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Actual
9/04/2014
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Date of last participant enrolment
Anticipated
23/08/2014
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Actual
26/08/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment outside Australia
Country [1]
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Pakistan
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State/province [1]
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Peshawar
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Office of US Foreign Disaster Assistance (OFDA)
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Address [1]
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2201 C St NW, Washington, DC 20520
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Country [1]
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United States of America
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Primary sponsor type
Charities/Societies/Foundations
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Name
Human Development Research Foundation
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Address
PO Box No. 759
G-10 Markaz
Islamabad, 4400
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Country
Pakistan
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
288878
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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World Health Organisation Ethics Review Committee
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Ethics committee address [1]
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Avenue Appia 20 1211 Geneva 27 Switzerland
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Ethics committee country [1]
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Switzerland
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Date submitted for ethics approval [1]
291876
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Approval date [1]
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23/12/2013
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Ethics approval number [1]
291876
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Summary
Brief summary
The rationale of the pilot study is to evaluate the feasibility of conducting a definitive RCT of a low intensity intervention to reduce mental health problems in people in low-resources settings. This study compares the relative efficacy of (a) Problem Management Plus, and (b) Enhanced Treatment as Usual. It is hypothesised that Problem Management Plus will lead to greater symptom reduction than Enhanced Treatment as Usual.
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Trial website
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Trial related presentations / publications
NA
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Public notes
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Contacts
Principal investigator
Name
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Prof Atif Rahman
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Address
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Institute of Psychology, Health and Society
University of Liverpool
Waterhouse Building, Block B, Brownlow Street,
Liverpool L69 3GL
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Country
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United Kingdom
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Phone
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+44(0)151 252 5509
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Fax
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+44(0)151 252 5285
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Email
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[email protected]
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Contact person for public queries
Name
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Atif Rahman
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Address
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Institute of Psychology, Health and Society
University of Liverpool
Waterhouse Building, Block B, Brownlow Street,
Liverpool L69 3GL
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Country
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United Kingdom
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Phone
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+44(0)151 252 5509
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Fax
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+44(0)151 252 5285
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Email
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[email protected]
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Contact person for scientific queries
Name
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Atif Rahman
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Address
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Institute of Psychology, Health and Society
University of Liverpool
Waterhouse Building, Block B, Brownlow Street,
Liverpool L69 3GL
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Country
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United Kingdom
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Phone
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+44(0)151 252 5509
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Fax
52384
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+44(0)151 252 5285
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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