Programma
Competitiveness and Innovation framework Programme - ICT Policy Support Programme
Data inizio
Data fine
Project type
EU Funds
Topics
Healthcare
Economic amount
14,000,000 €

The WHO has predicted that depression will be the most important cause of disability in 2030 in Europe. For this reason, the European Commission is funding projects aimed at finding effective and sustainable solutions for the care of a large number of people who are suffering at the same time. The MasterMind project has tested on a large scale an experimental tele-psychiatry service for the treatment and monitoring of patients suffering from mild and moderate depressive disorders, thanks to the use of several tools of computerized cognitive-behavioural therapy (cCBT) and videoconferencing between general practitioners and specialty doctors, psychologists and patients. The project was carried out in 23 facilities across Europe including regional and local health authorities, hospitals, research centres, ICT partners.

Three clinical pilot projects have been launched in Europe, including the one in Piedmont. The ASLTO3 Mental Health Centre involved the local health care structure of family doctors: 23 general practitioners, a psychologist, a psychiatrist and patients were involved in the clinical trial between September 2015 and February 2017.

Patient recruitment started after the platform was launched, the provision of video conferencing services, communication to all general practitioners at ASL and training for the doctors involved.

Videoconferencing was also used for consultations between psychiatric specialists from ASLTO3, in order to test a new form of treatment for patients.

The project also envisaged the construction of a European database to anonymously collect data on the treated patients , in order to evaluate the cCBT method in the treatment of mild and moderate depression and video conferencing support, regardless of the specific chosen instrument.

CSI-Piemonte played the role of ICT technical partner, collaborating with ASLTO3 of Collegno and ULSS9 of Treviso, for the implementation of the clinical pilot project in Piedmont, to support the translation of cCBT and data management towards ULSS9 of Treviso. In particular, the CSI was ASLTO3's technology partner, sharing its objectives and providing organisational advice on services and technical support.

Opportunities
  • The results obtained thanks to the consultation CCBT and video conferencing have identified the need to set up a psychiatric teleconsultation service spread throughout the territory: in residential areas where there is no specialist, first aid and outpatient clinic, where video conferencing between healthcare professionals can be validly used, including general practitioners, psychiatrists and psychologists.

  • The quantitative and qualitative analysis of the results today indicates the need for a sustainability assessment and an extension of the cCBT service to daily clinical practice. The results of the project in Piedmont, collected through focus groups and interviews according to the MAST methodology, clearly determined a clinical advantage in patients who performed the treatment of depression through cCBT and at the same time the videoconferencing service as a direct line to the psychologists and their general practitioner.

  • Possibility to offer a regional tele-psychiatry cCBT service for the treatment of mild-modern depression, extended to all ASL territorial services in a logic of scale and optimization of the drug cost.

  • Possibility of offering a regional videoconferencing service for psychiatrists and psychologists, and treatments to patients supported by online counselling of the psychologist.

Results
  • Creation of a European database on the use of cCBT and videoconferencing services for the quantitative and qualitative analysis of clinical trial results in 6,290 patients treated in 11 European countries, out of which about 350 in Italy.

  • 161 (35% men, 65% women) persons treated in Piedmont with cCBT, of which 67 (average age 49 years) also with videoconferencing (target: 1188 patients with suspicion of depressive disorders). 62% of patients were reported by their doctor, 26% by the psychiatrist and 12% spontaneously. The treatment lasted about three months, after which there was a reassessment of the patients' clinical condition, with interviews aimed also at assessing their service satisfaction.

  • At European level, the results in video conferencing use were: 58% of patients showed a reduction in symptoms (of which 39% in one category and 19% in two severity categories), while 36% were stable and 6% worsened. In Piedmont, 68% showed a reduction in symptoms (of which 48% in one category and 20% in two severity categories), while 24% were stable and 8% worsened.

  • At European level, the results in the use of cCBT were: about 30% of patients showed a reduction in symptoms. In Piedmont, 47% showed a reduction in symptoms of one category and 18% of two severity categories, while 29% were stable and 6% worsened.

  • The CSI has worked on software localization in Italian, presentation to the patient, training to general practitioners and specialists. He has worked with the partner company EAAD to manage the first level of technical support on the CCBT platform and to manage risks and contingencies. He collaborated with ASLTO3 on patient recruitment strategy, computerisation of procedures for recruiting and recording data, involvement and technical support to physicians, quantitative and qualitative data processing. He supported ASLTO3 in focus groups and semi-structured interviews, final evaluation of results and reporting.

  • The CSI has performed the expert role for: data management, definition of trial protocols and methodology for data collection and definition of related project indicators. It has contributed to the definition of the codebook encoding all project data. Implementation of online questionnaires for patients, doctors, psychologists and psychiatrists. Data processing, made anonymous, on patients, doctors and treatment trends for quantitative statistical analysis purposes. Data cleaning and continuous reporting.