Thread by @SimonGilbody

BASIL-C19 Trial. Targeting social isolation, loneliness & depression in older people. 🧵on our #UrgentPublicHealth trial during COVID. just published in @PLOSMedicine!
journals.plos.org/plosmedicine/a…

TL:DR COVID has increased social isolation, & risk of depression & toxic loneliness. A behavioural intervention helped older ppl maintain social interaction & networks. strong signal of effect in reducing loneliness. bigger trial underway. NHS is amazing.

Our #COVID19 trials programme is called Behavioural Activation in Social Isolation (BASIL), and here is a dodgy video of me:

when COVID stuck in early 2020 @MHARG_york @BASIL_Research @Keele_MHRes @AU_PrimaryCare @TEWVresearch repurposed our @NIHRresearch programme on the management of depression among older at-risk populations with multiple long term conditions
sites.google.com/nihr.ac.uk/bas…

instead of doing (yet another) #COVID #MentalHealth survey, we delivered a COVID trial to understand 'what works'? this was the first mental health trial adopted by the NIHR Urgent Public Health (UPH) programme @NIHRresearch
nihr.ac.uk/covid-studies/

We adapted & manualised an intervention that could be delivered at scale, based on what we know works for older people. Behavioural Activation works really well for depression in older people. good @Cochrane_CCMD review here cochranelibrary.com/cdsr/doi/10.10…

We made great use of scheduling, +vely reinforcing activity, and something called #FunctionalEquivalence to maintain social interaction & networks We worked with experts by experience. it all happened over the phone.

this was a pilot trial of n=96. it ran pretty well, and there was good engagement (av. x6 sessions) & retention (circa. 90%). we learned a lot about delivering a trial during COVID. trials became slicker & more efficient

#BASIL was not fully powered to test between-group effects, but there was a strong signal of effect in reducing loneliness at 3 months. we mustn't overinterpret this, and we will measure loneliness & depression (among other things) in a fully powered trial.....

A much bigger trial (called BASIL+) is now underway and recruiting in 20+ sites across the UK. doi.org/10.1186/ISRCTN…

a concurrent #ProcessEvaluation, led by the mighty @CizCG, tells us much more about trial delivery, how behavioural approaches work & about the impact of COVID restrictions on older ppl. qual results in the paper, more on this to come...

a couple of reflections:
[1] why so many surveys and so few trials in mental health? we wrote a paper on this with @docjohnwright @DavidEkers & @Cathy_Creswell in @TheLancetPsych
doi.org/10.1016/S2215-…

[2] coproduction is sooo important. BASIL worked really well and #teamBASIL experts-by-experience were at the centre of everything we did sites.google.com/nihr.ac.uk/bas…

[3] Cognitive & behavioural interventions could work in preventing loneliness, but they need to be scalable. there needs to be a big trial. ideally in #PrimaryCare.

[4] BASIL+ will be the largest trial in this area, & the results will be useful beyond COVID. great review of psychological approaches to loneliness by @Rozshafran1
doi.org/10.1016/j.cpr.…

we have a #CochraneReview with @Cochrane_CCMD underway, and BASIL will contribute to future meta-analyses
doi.org/10.1002/146518…

[5] the NHS [esp #PrimaryCare] has done amazing things during COVID. can't say this too often. we were helped by brilliant people from #NIHR #CRN. take a bow @NIHRCRN_NENCumb and our funder @NIHRresearch

[6] COVID has amplified loneliness. there is amazing work going on in this area. check out @UCL_Loneliness and other interesting approaches currently being trialled journals.plos.org/plosone/articl…

too many people to mention in #TeamBASIL.....many not on twitter.....@DavidEkers @CizCG @samgascoyne15 @laurenfburke @Peteyc73 @drandyclegg @Eloise_Ryde @lshears_ @_GemmaTT @TEWV @Keele_MHRes @ageukcampaigns @UniOfYork @HullYorkMed @NIHR_ARC_YH @BASIL_Research @MODS_Research_

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