The clinical effectiveness of using a predictive algorithm to guide antidepressant treatment in primary care (PReDicT): an open-label, randomised controlled trial

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  • dc.contributor.author Browning, Michael
  • dc.contributor.author Pérez Solá, Victor
  • dc.contributor.author Elices, Matilde
  • dc.contributor.author Dawson, Gerard R.
  • dc.date.accessioned 2021-07-08T06:51:13Z
  • dc.date.available 2021-07-08T06:51:13Z
  • dc.date.issued 2021
  • dc.description.abstract Depressed patients often do not respond to the first antidepressant prescribed, resulting in sequential trials of different medications. Personalised medicine offers a means of reducing this delay; however, the clinical effectiveness of personalised approaches to antidepressant treatment has not previously been tested. We assessed the clinical effectiveness of using a predictive algorithm, based on behavioural tests of affective cognition and subjective symptoms, to guide antidepressant treatment. We conducted a multicentre, open-label, randomised controlled trial in 913 medication-free depressed patients. Patients were randomly assigned to have their antidepressant treatment guided by a predictive algorithm or treatment as usual (TaU). The primary outcome was the response of depression symptoms, defined as a 50% or greater reduction in baseline score of the QIDS-SR-16 scale, at week 8. Additional prespecified outcomes included symptoms of anxiety at week 8, and symptoms of depression and functional outcome at weeks 8, 24 and 48. The response rate of depressive symptoms at week 8 in the PReDicT (55.9%) and TaU (51.8%) arms did not differ significantly (odds ratio: 1.18 (95% CI: 0.89-1.56), P = 0.25). However, there was a significantly greater reduction of anxiety in week 8 and a greater improvement in functional outcome at week 24 in the PReDicT arm. Use of the PReDicT test did not increase the rate of response to antidepressant treatment estimated by depressive symptoms but did improve symptoms of anxiety at week 8 and functional outcome at week 24. Our findings indicate that personalisation of antidepressant treatment may improve outcomes in depressed patients.
  • dc.description.sponsorship This project received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 696802.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Browning M, Bilderbeck AC, Dias R, Dourish CT, Kingslake J, Deckert J et al. The clinical effectiveness of using a predictive algorithm to guide antidepressant treatment in primary care (PReDicT): an open-label, randomised controlled trial. Neuropsychopharmacology. 2021;46(7):1307-14. DOI: 10.1038/s41386-021-00981-z
  • dc.identifier.doi http://dx.doi.org/10.1038/s41386-021-00981-z
  • dc.identifier.issn 0893-133X
  • dc.identifier.uri http://hdl.handle.net/10230/48110
  • dc.language.iso eng
  • dc.publisher Nature Research
  • dc.relation.ispartof Neuropsychopharmacology. 2021;46(7):1307-14
  • dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/696802
  • dc.rights © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Depression
  • dc.subject.keyword Human behaviour
  • dc.title The clinical effectiveness of using a predictive algorithm to guide antidepressant treatment in primary care (PReDicT): an open-label, randomised controlled trial
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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