1. www.clininf.eu www.surrey.ac.uk A Fair Test of the IAPT LTC/MUS Pathfinders IAPT data GBU analysis? Professor Simon Jones Ms Eleni Theodorou

2. www.clininf.eu www.surrey.ac.uk Objectives: To : Share our outline analysis plan What data to we have for the evaluation? What is Good, Bad, or Ugly?

3. www.clininf.eu www.surrey.ac.uk Subgroups of interest Long term condition Medically unexplained symptom YesNo Yes No Question: How can we identify people in the various groups? Data sources Fields and Codes GBU analysis

4. www.clininf.eu www.surrey.ac.uk Data Analysis for LTC & MUS service users For each of the subgroups Socio-Demographics profile Common mental health problems and other comorbidities describe duration and type of intervention outcomes of intervention explore and quantify relations between independent/predictor variables Question: Are there any other analysis which you would find useful?

5. www.clininf.eu www.surrey.ac.uk Outcome scales Personal Health Questionnaire (PHQ9) Generalised Anxiety Disorder (GAD) score Work and Social Adjustment Scale Score (W&SAS) Question: Which outcome is the most appropriate for MUS/LTC? GBU analysis

6. www.clininf.eu www.surrey.ac.uk Data Validation Study Primary care services Use of medication Psychotropic Non-psychotropic Referral rate Acute/Secondary Services Outpatient activity In-patient activity Accident and Emergency activity Validate the self-reported co-morbidities from IAPT dataset a against CHOICE (NIHR Programme Grant) data set based on routinely collected primary and secondary healthcare data sets (i.e. Doncaster and Newham).

7. www.clininf.eu www.surrey.ac.uk Economic analysis To ascertain the cost-effectiveness of the service in improving the outcomes of the different patient sub-groups Convert PHQ-9 into QALYs –See Brazier, Yang, Tsuchiya, Rowen (2010) A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures, Eur J Health Econ. To validate the map between PHQ-9 and EQ-5D we will also seek to identify a dataset where both PHQ-9 and EQ-5D are measured and observed and can be regressed along with interaction and polynomial effects to account for non- linearity and other confounding variables.

8. www.clininf.eu www.surrey.ac.uk IAPT Highlight Report

9. www.clininf.eu www.surrey.ac.uk IAPT MDS - Personal and demographic details M/RData Set Data Elements RNHS NUMBER RNHS NUMBER STATUS INDICATOR CODE MLOCAL PATIENT IDENTIFIER MORGANISATION CODE (CODE OF PROVIDER) MPERSON BIRTH DATE RPERSON GENDER CODE CURRENT MPOSTCODE OF USUAL ADDRESS RGENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION) RETHNIC CATEGORY RRELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION CODE RSEXUAL ORIENTATION (CURRENT) REX-BRITISH ARMED FORCES INDICATOR R LONG TERM PHYSICAL HEALTH CONDITION INDICATOR (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES)

10. www.clininf.eu www.surrey.ac.uk IAPT MDS - Disability M/RData Set Data Elements RNHS NUMBER RLOCAL PATIENT IDENTIFIER RORGANISATION CODE (CODE OF PROVIDER) RDISABILITY CODE 01Behaviour and Emotional 02Hearing 03Manual Dexterity 04Memory or ability to concentrate, learn or understand (Learning Disability)Learning Disability 05Mobility and Gross Motor 06Perception of Physical Danger 07Personal, Self Care and Continence 08Progressive Conditions and Physical Health (such as HIV, cancer, multiple sclerosis, fits etc) 09Sight 10Speech XXOther NNNo DISABILITYDISABILITY ZZNot Stated (PERSON asked but declined to provide a response)PERSON

11. www.clininf.eu www.surrey.ac.uk IAPT MDS - Referral details M/RData Set Data Elements RNHS NUMBER MLOCAL PATIENT IDENTIFIER MORGANISATION CODE (CODE OF PROVIDER) MSERVICE REQUEST IDENTIFIER RREFERRAL REQUEST RECEIVED DATE RSOURCE OF REFERRAL FOR MENTAL HEALTH RSERVICE REQUEST ACCEPTANCE INDICATOR RORGANISATION CODE (CODE OF COMMISSIONER) RPROVISIONAL DIAGNOSIS (ICD) R YEAR AND MONTH OF SYMPTOMS ONSET (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES) RPREVIOUS SYMPTOM INDICATOR R IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES CARE SPELL END CODE R END DATE (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES)

12. www.clininf.eu www.surrey.ac.uk IAPT MDS- Appointment details M/R Data Set Data Elements R NHS NUMBER M LOCAL PATIENT IDENTIFIER M ORGANISATION CODE (CODE OF PROVIDER) M SERVICE REQUEST IDENTIFIER M APPOINTMENT DATE R CARE PROFESSIONAL ROLE CODE (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES) M ATTENDED OR DID NOT ATTEND CODE R CLINICAL CONTACT DURATION OF APPOINTMENT R APPOINTMENT TYPE (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES) R CONSULTATION MEDIUM USED R THERAPY TYPE (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES) THERAPY TYPE (IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES) (Up to four types may be recorded for each APPOINTMENT) APPOINTMENT R EMPLOYMENT STATUS R EMPLOYMENT SUPPORT SUITABILITY INDICATOR R EMPLOYMENT SUPPORT REFERRAL DATE R PSYCHOTROPIC MEDICATION USAGE R STATUTORY SICK PAY INDICATOR R PHQ-9 TOTAL SCORE R GENERALISED ANXIETY DISORDER SCORE R WORK AND SOCIAL ADJUSTMENT SCALE SCORE R AGORAPHOBIA MOBILITY INVENTORY SCORE (WHEN ACCOMPANIED) R AGORAPHOBIA MOBILITY INVENTORY SCORE (WHEN ALONE) R AGORAPHOBIA SCORE R GENERALISED ANXIETY DISORDER PENN STATE WORRY SCORE R HEALTH ANXIETY INVENTORY SHORT WEEK SCALE SCORE R OBSESSIVE COMPULSIVE DISORDER INVENTORY SCORE R PANIC DISORDER SEVERITY SCALE SCORE R POST TRAUMATIC STRESS DISORDER IMPACT OF EVENTS SCALE REVISED SCORE R SOCIAL PHOBIA INVENTORY SCORE R SOCIAL PHOBIA SCORE R SPECIFIC PHOBIA SCORE

13. www.clininf.eu www.surrey.ac.uk Thanks for listening Simon Jones simonjones@surrey.ac.uk Acknowledgements: XXX