Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough

Objective To assess the effectiveness of NHS Talking Therapies (NHSTT) service for working-age adults with mild to moderate depression or anxiety and to evaluate the impact of multiple physical long-term conditions (LTCs) on treatment outcomes.Method We have linked routinely collected data from the...

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Main Authors: Matthew Broadbent, Matthew Hotopf, Brendon Stubbs, Lisa Harber-Aschan, Stephani Hatch, David Armstrong, Ioannis Bakolis, Alex Dregan, Amy Ronaldson, Nicusor Sima
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Mental Health
Online Access:https://mentalhealth.bmj.com/content/28/1/e301632.full
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author Matthew Broadbent
Matthew Hotopf
Brendon Stubbs
Lisa Harber-Aschan
Stephani Hatch
David Armstrong
Ioannis Bakolis
Alex Dregan
Amy Ronaldson
Nicusor Sima
author_facet Matthew Broadbent
Matthew Hotopf
Brendon Stubbs
Lisa Harber-Aschan
Stephani Hatch
David Armstrong
Ioannis Bakolis
Alex Dregan
Amy Ronaldson
Nicusor Sima
author_sort Matthew Broadbent
collection DOAJ
description Objective To assess the effectiveness of NHS Talking Therapies (NHSTT) service for working-age adults with mild to moderate depression or anxiety and to evaluate the impact of multiple physical long-term conditions (LTCs) on treatment outcomes.Method We have linked routinely collected data from the NHSTT services in South London (UK) with primary care data for aged 18–64 years who had accessed the services between August 2008 and March 2021. The main outcome measures were NHSTT service key performance indicators of ‘recovery’ and ‘reliable improvement’. Multiple and specific physical LTCs represented the exposure of interest. Cox proportional hazard models were used to assess associations between physical LTC exposures and outcomes.Findings Among 35 814 adults (mean age=37, 67% women) attending the NHSTT, physical LTCs were associated with moderately lower ‘recovery’ rate (adjusted HR (aHR)=0.91, 95% CI 0.88 to 0.95) relative to no LTCs. A dose–response relationship was also observed: the likelihood of ‘recovery’ decreased with the number of physical LTCs (one condition: aHR=0.95, 95% CI 0.91 to 0.98; two conditions: aHR=0.88, 95% CI 0.83 to 0.93; three conditions: aHR=0.82, 95% CI 0.75 to 0.91; four or more conditions: aHR=0.72, 95% CI 0.61 to 0.85).Conclusion Among working-age adults, the effectiveness of NHSTT services varied with the number and type of physical LTCs. These findings highlight the need for tailored interventions for patients with multiple physical LTCs to improve treatment outcomes.
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spelling doaj-art-1d85d6d68651424bad38c8ebf8dc11bb2025-08-20T03:07:41ZengBMJ Publishing GroupBMJ Mental Health2755-97342025-05-0128110.1136/bmjment-2025-301632Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London boroughMatthew Broadbent0Matthew Hotopf1Brendon Stubbs2Lisa Harber-Aschan3Stephani Hatch4David Armstrong5Ioannis Bakolis6Alex Dregan7Amy Ronaldson8Nicusor Sima9NIHR Maudsley Biomedical Research Centre, SLAM, London, UKDepartment of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology, and Neurosciences, London, UKDepartment of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology, and Neurosciences, London, UKDepartment of Sociology, Stockholm University, Stockholm, SwedenDepartment of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology, and Neurosciences, London, UKPopulation Health Sciences, King’s College London, London, UKBiostatistics and Health Informatics, King’s College London School of Social Science and Public Policy, London, UKDepartment of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology, and Neurosciences, London, UKDepartment of Biostatistics and Health Informatics, King’s College London, London, UKDepartment of Technological Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca, RomaniaObjective To assess the effectiveness of NHS Talking Therapies (NHSTT) service for working-age adults with mild to moderate depression or anxiety and to evaluate the impact of multiple physical long-term conditions (LTCs) on treatment outcomes.Method We have linked routinely collected data from the NHSTT services in South London (UK) with primary care data for aged 18–64 years who had accessed the services between August 2008 and March 2021. The main outcome measures were NHSTT service key performance indicators of ‘recovery’ and ‘reliable improvement’. Multiple and specific physical LTCs represented the exposure of interest. Cox proportional hazard models were used to assess associations between physical LTC exposures and outcomes.Findings Among 35 814 adults (mean age=37, 67% women) attending the NHSTT, physical LTCs were associated with moderately lower ‘recovery’ rate (adjusted HR (aHR)=0.91, 95% CI 0.88 to 0.95) relative to no LTCs. A dose–response relationship was also observed: the likelihood of ‘recovery’ decreased with the number of physical LTCs (one condition: aHR=0.95, 95% CI 0.91 to 0.98; two conditions: aHR=0.88, 95% CI 0.83 to 0.93; three conditions: aHR=0.82, 95% CI 0.75 to 0.91; four or more conditions: aHR=0.72, 95% CI 0.61 to 0.85).Conclusion Among working-age adults, the effectiveness of NHSTT services varied with the number and type of physical LTCs. These findings highlight the need for tailored interventions for patients with multiple physical LTCs to improve treatment outcomes.https://mentalhealth.bmj.com/content/28/1/e301632.full
spellingShingle Matthew Broadbent
Matthew Hotopf
Brendon Stubbs
Lisa Harber-Aschan
Stephani Hatch
David Armstrong
Ioannis Bakolis
Alex Dregan
Amy Ronaldson
Nicusor Sima
Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough
BMJ Mental Health
title Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough
title_full Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough
title_fullStr Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough
title_full_unstemmed Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough
title_short Physical long-term conditions and the effectiveness of England’s NHS Talking Therapies programme for working-age adults: findings from a South London borough
title_sort physical long term conditions and the effectiveness of england s nhs talking therapies programme for working age adults findings from a south london borough
url https://mentalhealth.bmj.com/content/28/1/e301632.full
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