Details of HTA project
Last updated: 26 August 2008 - Next update due: 2 September 2008
Research type: |
Primary Research (e.g. trial) |
Project title: |
Psychological interventions for postnatal depression - randomised controlled trial and economic evaluation (PONDER) |
Project ref: |
99/33/51 |
Cost: |
£832,178 |
Chief Investigator : |
Dr C Jane Morrell, Research Leader, School of Human and Health Sciences, University of Huddersfield |
Start Date: |
April 2003. |
Publication date: |
March 2009. This project is at the editorial review stage. Delays in the review process can cause the forecast publication date to be delayed. |
Plain English Summary |
About 13% women may suffer from Postnatal Depression (PND) in the first year after their baby is born. In the past, GPs and Health Visitors (HVs) did not know how these women were feeling, and not all women received the support that might have helped them. The PONDER Trial is funded by the NHS R&D HTA programme and will be the largest randomised controlled trial of its kind. The trial will find out how helpful it might be for specially trained HVs to offer a 'psychological intervention' to support women, and to help them to recover more quickly. Aim: The PoNDER Trial will assess the costs and effectiveness of two HV psychological interventions for PND. Scope and Methods: From 93 General Practices, the trial aims to recruit 4,000 women. In intervention practices, women with PND will be identified by HVs who have received special training in detecting PND. Affected women will be offered up to 8 weekly one-hour intervention visits from a specially trained HV. All women who take part will be asked to return a postal questionnaire when their baby is 6 weeks old, then 6, 12 and 18 months old. This will help us look at the general health of all postnatal women. The outcomes for the women in the intervention group will be compared with the outcomes for women in the control group. Outcomes: We will monitor the proportion of women who are depressed at 6, 12 and 18 months postnatally as well as family well-being and infant progress to 18 months. Costs and benefits will be considered from an NHS perspective. Results: To date, 3425 women have consented to take part in the trial. |
Abstract: |
The study aims to assess the costs and effectiveness and broad impact of two health visitor (HV) psychological interventions for Postnatal Depression (PND). Some PND resolves spontaneously, but it can be enduring with a detrimental effect on infants and women's partners. There is a very small risk of suicide and infanticide in some severely depressed women. HVs use different approaches to identify and support women with PND. Much PND remains unidentified. There is weak evidence about the most effective intervention for treating women with PND. This trial will be the first study of a one-to-one HV intervention for PND based in routine primary care. Of the 93 practices recruited to the trial, 36 have been randomly allocated to represent the control or treatment as usual group. Among the 57 intervention group practices, the HVs have already received additional training in the detection and management of PND, using ratified, distinct, manualised training programmes. One programme is for the HV to deliver a Person-Centred Approach and the other for a Cognitive-Behavioural Approach. These HVs will identify women who are experiencing depression at 6-8 weeks postnatally. A definite diagnosis of depression (defined by ICD-10) will be confirmed using the Schedule for Clinical Assessment in Neuropsychiatry. Affected women will be offered a one-hour visit per week, for a maximum of eight weeks, focusing on the needs of the mother (rather than the baby or other children). All women in the study will be sent a questionnaire when their baby is six, twelve and eighteen months old, to examine health status, change in symptoms, hospital admissions, NHS service use, family well-being and infant progress. The economic evaluation will establish any differences in costs associated with the two interventions, and relate the cost to any health benefits associated with the intervention. Costs and benefits will be considered from an NHS perspective for both the mother and child. |
MeSH* index primary terms: |
COUNSELING; DEPRESSION-POSTNATAL Q-psychology |
MeSH* index secondary terms: |
HUMAN; RANDOMIZED-CONTROLLED-TRIAL; CLINICAL-TRIAL; COST-BENEFIT-ANALYSIS |
NRR* number, if applicable: |
N0484121626 (*National Research Register) |
ISRCTN* number: | ISRCTN 92195776 (*International Standard Randomised Controlled Trial Number) URL of this project on the Controlled Trials Website: http://www.controlled-trials.com/ISRCTN92195776 |
Project Protocol: |
Project protocol not available |
URL of this page: |
http://www.hta.ac.uk/1336 |
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