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    Digitally enabled therapies for adults with depression: early value assessment

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    2 The technology

    Technologies

    2.1 Digitally enabled therapies are a treatment option for adults with depression. They are technologies, used online or through apps, that deliver a substantial portion of therapy through their content. They are delivered with support from a trained practitioner in NHS Talking Therapies Services who facilitates the self-help intervention, encourages completion, and reviews progress and outcomes. Six digitally enabled therapies which include materials based on structured cognitive behavioural therapy (CBT) were included in this evaluation:

    • Beating the Blues (365 Health Solutions) is an online CBT programme comprising of 8 modules.

    • Deprexis (Ethypharm Digital Therapy) is an online CBT programme comprising of 10 modules.

    • Iona Mind (Iona Mind) is an app-based CBT programme which uses machine learning to anticipate and adapt the programme to a person's needs.

    • Minddistrict (Minddistrict) is an online CBT programme comprising of 8 modules.

    • Space from Depression (SilverCloud) is an online CBT programme comprising of 5 modules.

    • Wysa (Wysa) is an artificial intelligence-based app with a CBT-based self-help programme.

    Care pathway

    2.2 NHS Talking Therapies (formerly Improving Access to Psychological Therapies or IAPT) provides NICE recommended psychological therapies for depression using a stepped care approach. For adults with depression, treatment options should be discussed and the choice of treatment matched to their clinical needs and preferences. NICE's clinical guideline on depression in adults: treatment and management recommends several treatment options which can be used as first-line treatments for less and more severe depression. Guided self-help (including digitally enabled therapies) is an option for treating both less severe and more severe episodes of depression. It should be considered first for most people with less severe depression as it is the least intrusive and least resource intensive treatment option. Although guided self-help is also recommended for adults with more severe depression, other treatment choices with more therapist contact should be considered first. Monitoring for treatment concordance, side effects, and suicidal ideation should be done by a healthcare professional. Routine outcome monitoring and follow up should be considered.

    Comparator

    2.3 The comparators are the treatments offered for a new episode of less severe depression or more severe depression as described in sections 1.5 and 1.6 in NICE's clinical guideline on depression in adults: treatment and management. These treatments are delivered by NHS Talking Therapies services.