Defeating Fear With Exposure Therapy Delivered by Mental Health Nurses in Primary Care for Anxiety Disorders in Older Adults - a Cluster-randomised Controlled Trial

What this Trial Is About

Researchers are evaluating the cost-effectiveness and impact of exposure therapy (ET) delivered by trained mental health nurses (MHNs) compared to usual care (UC) for older adults with anxiety disorders in primary care settings. The study focuses on people aged 65 and older diagnosed with anxiety disorders such as Generalized Anxiety Disorder, Agoraphobia, Panic Disorder, or Social Anxiety Disorder. It aims to address the underdiagnosis and undertreatment of anxiety in older adults, considering patient preferences and barriers like age-related changes and transportation issues. Participants in the ET group will receive eight therapy sessions over 12 weeks, with the first session lasting 60 minutes and the remaining sessions 30 minutes each. These sessions are tailored to individual needs and delivered by MHNs working in primary care centers. The UC group will receive standard care based on general practitioner guidelines, which may include medication, e-learning, psycho-education, problem-solving therapy, or referral to mental health institutions. Throughout the study, participants will complete questionnaires before, during, and after treatment, with follow-ups extending to one year. Researchers will assess anxiety severity using the Geriatric Anxiety Inventory, quality of life with the EuroQol 5 Dimension 5 Level version, and societal costs through a psychiatric illness cost questionnaire. The study will also monitor secondary outcomes like depressive symptoms, general functioning, and medication use. Participation involves no known risks, and the study expects to provide insights into improving anxiety care for older adults.

Exposure Therapy for Late-life Anxiety