EMBED: A stepped wedge cluster randomised trial of a tailored, integrated model of care to reduce symptoms of depression in home aged care

  • Davison, Tanya (Primary Chief Investigator (PCI))
  • Bhar, Sunil (Chief Investigator (CI))
  • Wuthrich, Viviana M. (Chief Investigator (CI))
  • Almeida, Osvaldo (Chief Investigator (CI))
  • Schofield, Penelope Ellen (Chief Investigator (CI))
  • Jeon, Yun-Hee (Chief Investigator (CI))
  • Numbers, Katya (Chief Investigator (CI))
  • Barker, Anna (Chief Investigator (CI))
  • Williams, Helena (Chief Investigator (CI))
  • Milte, Rachel K. (Chief Investigator (CI))
  • Nguyen, Tuan Anh (Chief Investigator (CI))
  • Quinn, Stephen (Chief Investigator (CI))
  • Flicker, Leon (Chief Investigator (CI))
  • Heiss, Leah (Chief Investigator (CI))
  • Soh, Sze-Ee (Associate Investigator (AI))

Project: Research

Project Details

Project Description

Up to 50% of older people who receive aged care services at home display symptoms of depression. With 1 million home aged care recipients in Australia and continued expansion of the sector, this is a rapidly growing public health concern. The Royal Commission into Aged Care Quality and Safety highlighted the crisis in mental health, with aged care staff inadequately trained to detect and manage depression. Frail older Australians with depression—particularly those living in rural and remote areas—have poor access to mental health services and few receive nonpharmacological treatments, despite their excellent safety profile and established evidence of efficacy.
To address this gap, our industry-academic partnership has developed an innovative, feasible and sustainable model of care to improve the detection and treatment of depression in home aged care, and to address the dual stigma of mental health and ageing. Enhanced Management of home-Based Elderly with Depression (EMBED) was co-designed with frontline staff and consumers, and includes staff training in depression management, routine screening, assessment, and treatments tailored to older people’s needs.
Using a stepped wedge cluster randomised controlled trial with home aged care clients with depression from 15 home care sites, we will determine the impact of EMBED compared to usual care. The primary outcome is symptoms of depression, and secondary outcomes include stigma, anxiety, loneliness, access to mental health care and cost-effectiveness. The research will examine the implementation of EMBED within standard service delivery, using the RE-AIM framework.
This research translates our previous evidence of effective strategies into a comprehensive model of care suitable for broad implementation across Australia evaluated in routine care. It is a fundamental departure from existing approaches, where mental health care and aged care exist in siloes and the needs of older people with depression are neglected.
Effective start/end date1/06/2231/05/25