PRimary carE digital Support ToOl in mental health (PRESTO): Design, development and study protocols

Span J Psychiatry Ment Health. 2024 Apr-Jun;17(2):114-125. doi: 10.1016/j.rpsm.2021.04.003. Epub 2021 Apr 29.

Abstract

Background: About 30-50% of Primary Care (PC) users in Spain suffer mental health problems, mostly mild to moderate anxious and depressive symptoms, which account for 2% of Spain's total Gross domestic product and 50% of the costs associated to all mental disorders. Mobile health tools have demonstrated to cost-effectively reduce anxious and depressive symptoms while machine learning (ML) techniques have shown to accurately detect severe cases. The main aim of this project is to develop a comprehensive ML digital support platform (PRESTO) to cost-effectively screen, assess, triage, and provide personalized treatments for anxious and depressive symptoms in PC.

Methods: The project will be carried out in 3 complementary phases: First, a ML predictive severity model will be built based on all the cases referred to the PC mental health support programme during the last 5 years in Catalonia. Simultaneously, a smartphone app to monitor and deliver psychological interventions for anxiety and depressive symptoms will be developed and tested in a clinical trial. Finally, the ML models and the app will be integrated in a comprehensive decision-support platform (PRESTO) which will triage and assign to each patient a specific intervention based on individual personal and clinical characteristics. The effectiveness of PRESTO to reduce waiting times in receiving mental healthcare will be tested in a stepped-wedge cluster randomized controlled trial in 5 PC centres.

Discussion: PRESTO will offer timely and personalized cost-effective mental health treatment to people with mild to moderate anxious and depressive symptoms. This will result in a reduction of the burden of mental health problems in PC and on society as a whole.

Trial registration: The project and their clinical trials were registered in Clinical Trials.gov: NCT04559360 (September 2020).

Keywords: Machine learning; Mental health; Primary care; Smartphone app; mHealth.

Publication types

  • Research Support, Non-U.S. Gov't
  • Clinical Trial Protocol

MeSH terms

  • Anxiety / therapy
  • Depression* / therapy
  • Humans
  • Machine Learning
  • Mobile Applications*
  • Primary Health Care* / methods
  • Research Design
  • Smartphone
  • Spain
  • Telemedicine* / methods

Associated data

  • ClinicalTrials.gov/NCT04559360