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Open Access Study protocol

Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial

Judith Gellatly1*, Peter Bower2, Dean McMillan3, Christopher Roberts4, Sarah Byford3, Penny Bee1, Simon Gilbody3, Catherine Arundel3, Gillian Hardy5, Michael Barkham5, Shirley Reynolds6, Lina Gega7, Patricia Mottram8, Nicola Lidbetter9, Rebecca Pedley1, Emily Peckham3, Janice Connell10, Jo Molle11, Neil O’Leary4 and Karina Lovell1

Author Affiliations

1 School of Nursing, Midwifery & Social Work, The University of Manchester, Manchester, UK

2 Centre for Primary Care, The University of Manchester, Manchester, UK

3 Department of Health Sciences, University of York, York, UK

4 School of Epidemiology and Health Sciences, The University of Manchester, Manchester, UK

5 Department of Psychology, University of Sheffield, Sheffield, UK

6 School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK

7 Insight Healthcare, Newcastle Upon Tyne, UK

8 Cheshire and Wirral Partnership NHS Foundation Trust, Wallasey, UK

9 Anxiety UK, Manchester, UK

10 ScHARR, University of Sheffield, Sheffield, UK

11 Norwich Medical School, University of East Anglia, Norwich, UK

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Trials 2014, 15:278  doi:10.1186/1745-6215-15-278

Published: 10 July 2014

Abstract

Background

UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required.

Methods/Design

Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments.

Discussion

This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD.

Trial registration

Current Controlled Trials: ISRCTN73535163. Date of registration: 5 April 2011

Keywords:
Obsessive compulsive disorder; Guided self-help; Computerised cognitive behaviour therapy; Cognitive behaviour therapy; Exposure and response prevention