Improvement in IAPT outcomes over time: are they driven by changes in clinical practice?

Rob Saunders,Stephen Pilling,John Cape,Renuka Jena,Mirko Cirkovic,Joshua E.J Buckman,Judy Leibowitz,Nicole Main,Elisa Aguirre,Jon Wheatley

doi:10.1017/s1754470x20000173

Abstract

(1)How changes to treatment-delivery factors are associated with IAPT patient outcomes.(2)The link between clinical practice and potential service performance.(3)How analysing routinely collected data can be used to inform service improvement.

Highlights

The Improving Access to Psychological Therapies (IAPT) programme was developed in response to the rising burden of depression and anxiety disorders in England (Clark, 2011)
The dataset used for the current analysis includes routinely collected data from all patients who had a course of IAPT treatment in North and Central East London (NCEL) IAPT services, were in caseness at the start of treatment and completed pre- and post-treatment outcome measures
Descriptive analyses Number of sessions and duration of treatment The average number of treatment sessions per year for patients who completed a course of treatment across the NCEL services is presented in the left-hand panel of Fig. 2, with the yearly percentage of patients reaching recovery and reliable improvement superimposed

Summary

Introduction

The Improving Access to Psychological Therapies (IAPT) programme was developed in response to the rising burden of depression and anxiety disorders in England (Clark, 2011). In order to meet the growing demand, training of increasing numbers of clinicians is required, with an aim of over 10,500 new therapists to be trained by 2021 (Clark, 2018) Such is the perceived success of the programme that countries such as Australia (Cromarty et al, 2016) and Norway (Knapstad et al, 2018) have adopted versions of the IAPT model for delivery in their own healthcare systems. Some received just an assessment and advice or signposting, whereas others (582,556 individuals) received a course of IAPT treatment (defined as two or more treatment sessions) (NHS Digital, 2019) This represents an 11.4% increase in referrals and a 5% increase in treated patients from the previous year. Latest reports indicate that 52.1% of patients receiving a course of treatment recovered, up from 50.8% in the previous year (NHS Digital, 2019)

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Discussion

Conclusion