Feasibility, acceptability and costs of nurse-led Alpha-Stim cranial electrostimulation to treat anxiety and depression in university students

• Published in: BMC family practice 2022-04, Vol.23 (1), p.97-97, Article 97
• Main Authors: Royal, Simon, Keeling, Stuart, Kelsall, Nick, Price, Larry, Fordham, Richard, Xydopoulos, Georgios, Dawson, Gerard R, Kingslake, Jonathan, Morriss, Richard
• Format: Article
• Language: English
• Subjects: Adult; Antidepressants; Anxiety; Anxiety - therapy; Anxiety disorders; Care and treatment; Cognitive behavioral therapy; Cognitive therapy; College students; Complications and side effects; COVID-19; Depression - therapy; Electric Stimulation Therapy; Feasibility Studies; Female; Health aspects; Humans; Male; Mental depression; Mental disorders; Mental illness; Nurse's Role; Patient outcomes; Psychological aspects; Students - psychology; Universities; University students; Young Adult
• ISSN: 2731-4553; 2731-4553; 1471-2296
• DOI: 10.1186/s12875-022-01681-3

Only a relatively low proportion of university students seek help for anxiety and depression disorders, partly because they dislike current drug and psychological treatment options and would prefer home-based care. The aim of this study is to determine the feasibility, acceptability and cost utility of Alpha-Stim cranial electrostimulation (CES) delivered through a nurse led primary care clinic as a daily treatment for anxiety and depression symptoms by the student at home in contrast to usual primary care. Feasibility and acceptability of a nurse led clinic offering Alpha-Stim CES in terms of the take up and completion of the six-week course of Alpha-Stim CES. Change in score on the GAD-7 and PHQ-9 as measures of anxiety and depression symptoms at baseline and at 8 weeks following a course of Alpha-Stim CES. Similar evaluation in a non-randomised control group attending a family doctor over the same period. Cost-utility analysis of the nurse led Alpha-Stim CES and family doctor pathways with participants failing to improve following further NICE Guideline clinical care (facilitated self-help and cognitive behaviour therapy). Of 47 students (mean age 22.1, years, 79% female opting for Alpha-Stim CES at the nurse-led clinic 46 (97.9%) completed a 6-week daily course. Forty-seven (47) students comprised a comparison group receiving usual family doctor care. Both Alpha-Stim CES and usual family doctor care were associated with large effect size reductions in GAD-7 and PHQ-9 scores from baseline to 8 weeks. There were no adverse effects and only one participant showed a clinically important deterioration in the Alpha-Stim group. In the cost utility analysis, Alpha-Stim CES was a cheaper option than usual family doctor care under all deterministic or probabilistic assumptions. Nurse delivered Alpha-Stim CES may be a feasible, acceptable and cheaper way of providing greater choice and home-based care for some university students seeking help from primary care with new presentations of anxiety and depression.