Exposure Therapy for Late-life Anxiety
Defeating Fear With Exposure Therapy Delivered by Mental Health Nurses in Primary Care for Anxiety Disorders in Older Adults - a Cluster-randomised Controlled Trial
ProPersona
170 participants
Feb 12, 2025
INTERVENTIONAL
Conditions
Summary
The primary objective is to evaluate the (cost-)effectiveness of exposure therapy (ET) delivered by trained mental health nurses (MHNs) in terms of anxiety symptoms and quality of life for late life anxiety disorders in primary care compared to usual care (UC). UC is not restricted, and the general practitioner (GP) is encouraged to work according to the guidelines of the Dutch College of GPs. Participants in the ET group will receive 30-minute ET sessions delivered by a trained mental health nurse, during 8 sessions within the span of 12 weeks. Participants will fill in questionnaires before, during and after treatment, with a 1-year follow-up. The main study parameters are anxiety severity, quality of life and societal costs.
Eligibility
Inclusion Criteria3
- A primary DSM-5 anxiety disorder using the Mini Internationaal Neuropsychiatrisch Interview (MINI).
- One of the following DSM-5 anxiety disorders will be diagnosed, Generalized Anxiety Disorder, Agoraphobia, Panic Disorder or Social Anxiety Disorder.
- Participants are required to be sufficient in Dutch.
Exclusion Criteria5
- Moderate to severe suicidality, which will be determined using the MINI
- Chronic and interfering substance or alcohol abuse
- Having received previous psychotherapy including exposure in the past year. -
- Antidepressants and benzodiazepines use are allowed if on a stable dose for a minimum of 8 weeks.
- Participants will be excluded if they score lower than 18 points on the MoCa (115). A score of \<18 is indicative for moderate to severe cognitive impairment. - Participants will be excluded if they are terminally ill.
Interventions
The exposure therapy will be given by the mental health care nurses (MHN) working in primary care centres. In addition, there will be eight sessions spread over 12 weeks. The first session will be 60 minutes long and the rest will be 30 minutes long.
The Usual Care group will receive care based on the general practitioners guidelines for anxiety disorders in the primary care center. This will entail possible medication, e-learning or psycho-education, problem solving therapy or a referral to a mental health institution.
Locations(1)
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NCT06770517