A Qualitative Study Exploring the Experience and Value of the Cranial Electrical Stimulation (CES) Device Alpha-Stim AID for a Social Prescribing Service Patients with Symptoms of Anxiety — Oak Academic Publishing
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A Qualitative Study Exploring the Experience and Value of the Cranial Electrical Stimulation (CES) Device Alpha-Stim AID for a Social Prescribing Service Patients with Symptoms of Anxiety
Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
,
Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
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Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
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University of Northampton, Northampton, UK
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General Practice Alliance, Northampton, UK
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General Practice Alliance, Northampton, UK
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General Practice Alliance, Northampton, UK
1 Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
2 Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
3 Northamptonshire Healthcare NHS Foundation Trust, Northampton, UK
<b>Background</b><b>: </b>Alpha-Stim AID is a self-administered cranial electrotherapy stimulation (CES) device with evidence of effectiveness in treating symptoms of anxiety. In this study, Alpha-Stim AID was offered through a United Kingdom (UK) primary care social prescription service to patients with symptoms of anxiety. <b>Methods</b><b>: </b>This study explored the experience and impact of using Alpha-Stim AID and social prescribing service through in-depth interviews. Out of a sample of 30 using Alpha-Stim AID, thirteen participants consented to be interviewed. The age range of participants was 27 - 68 years (<i>M</i> = 50.67, <i>SD</i> = 13.27); eight (62%) were female and five (38%) were male. Data were analysed using thematic analysis. <b>Results</b><b>: </b>There was support for the acceptability and useability of Alpha-Stim AID. Most participants described a positive impact in their lives. Themes that emerged offered insights into the welcomed addition of Alpha-Stim AID to anxiety treatment and its ease of use, how Alpha-Stim AID had positive impacts, the benefits of social prescribing service, and how improvements gained enabled engagement in socialising, activities, and further mental health recovery. <b>Conclusions</b><b>: </b>It is important to identify anxiety symptoms and offer patients a choice of treatment options beyond medication. The results support the use of Alpha-Stim AID as a treatment option for people with symptoms of anxiety using social prescribing services.
APA (2013). Diagnostic and Statistical Manual of Mental Disorders. Ame rican Psychia t ric Association, 21, 591-643. https://doi.org/10.1176/appi.books.9780890425596
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of Anxiety Disorders. Dialogues in Clinical Neuroscience, 19, 93-107. https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
Barclay, T. H., & and Barclay, R. D. (2014). A Clinical Trial of Cranial Electrotherapy Stimulation for Anxiety and Comorbid Depression. Journal of Affective Disorders, 164, 171-177. https://doi.org/10.1016/j.jad.2014.04.029
Bespalov, A. Y., van Gaalen, M. M., & Gross, G. (2010). Antidepressant Treatment in Anxiety Disorders. In M. B. Stein, & T. Steckler (Eds.), Behavioral Neurobiology of Anxiety and Its Treatments (pp. 361-390). Springer. https://doi.org/10.1007/7854_2009_3
Bickerdike, L., Booth, A., Wilson, P. M., Farley, K., & Wright, K. (2017) Social Prescribing: Less Rhetoric and More Reality. A Systematic Review of the Evidence. BMJ Open, 7, e013384. https://doi.org/10.1136/bmjopen-2016-013384
Braun, V., & Clarke, V. (2006). Using Thematic Analysis in Psychology. Qualitative R e search in Psychology, 3 , 77-101. https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2021). Thematic Analysis A Practical Guide . Sage. https://doi.org/10.1007/978-3-319-69909-7_3470-2
Bystritsky, A., Kerwin, L., & Feusner, J. (2008). A Pilot Study of Cranial Electrotherapy Stimulation for Generalized Anxiety Disorder. Journal of Clinical Psychiatry , 69 , 412-417. https://doi.org/10.4088/JCP.v69n0311
Ching, P. Y., Hsu, T., Chen, G., Pan, C. C., Chu, C. S., & Chou, P. H. (2022). Efficacy and Tolerability of Cranial Electrotherapy Stimulation in the Treatment of Anxiety: A Systemic Review and Meta-Analysis. Frontiers in Psychiatry, 13 , Article ID: 899040. https://doi.org/10.3389/fpsyt.2022.899040
Costa, A., Sousa, C. J., Seabra, P. R. C., Virgolino, A., Santos, O., Lopes, J., Henriques, A., Nogueira, P., & Alarcão, V. (2021). Effectiveness of Social Prescribing Programs in the Primary Health-Care Context: A Systematic Literature Review. Sustainability, 13, Article No. 2731. https://doi.org/10.3390/su13052731
Culpepper, L. (2009). Generalized Anxiety Disorder and Medical Illness. Journal of Clinical Psychiatry, 70, 20-24. https://doi.org/10.4088/JCP.s.7002.04
Denzin, N. K., & Lincoln, Y. S. (2005). Introduction: The Discipline and Practice of Qualitative Research. In N. Denzin, & Y. Lincoln (Eds.), The SAGE Handbook of Qualitative Research (3rd ed., pp. 1-32). Sage.
Electromedical Products International Inc. (2022). https://www.alpha-stim.com/
Griffiths, C. A., & Griffiths, L. J. (2014). Recovery and Reliable Change Rates for Patients Scoring Severe on Depression, Anxiety or Impaired Functioning in a Psychological Therapies Service: IAPT. Mental Health Review Journal, 20, 28-35. https://doi.org/10.1108/MHRJ-06-2014-0022
Griffiths, C., Leathlean, C., Smart, D., Zafar, A., Hall, C.-L., & Deeks, S. (2021). Alpha-Stim Cranial Electrotherapy Stimulation (CES) for Anxiety Treatment: Outcomes in a United Kingdom (UK) Primary Care Practice. Open Journal of Psychiatry, 11, 186-201. https://doi.org/10.4236/ojpsych.2021.113015
Griffiths, C., Walker, K., & Jiang, H. (2023). The Experience of Using Alpha-Stim AID Cranial Electrotherapy Stimulation (CES) for Symptoms of Anxiety. F1000 Research . https://doi.org/10.12688/f1000research.128323.1
Grycuk, L., Moruzzi, F., Bardjesteh, E., Gaughran, F., Campbell, E. C., & Schmidt, U. (2021). Participant Experiences of Transcranial Direct Current Stimulation (tDCS) as a Treatment for Antipsychotic Medication Induced Weight Gain . Fron tiers in Psycho l ogy, 12 , Article ID: 694203. https://doi.org/10.3389/fpsyg.2021.694203
Guest, G., Bunce, A., & Johnson, L. (2006). How Many Interviews Are Enough? An Experiment with Data Saturation and Variability. Field Methods, 18, 59-82. https://doi.org/10.1177/1525822X05279903
Gyani, A., Shafran, R., Layard, R., & Clark, D. M. (2013). Enhancing Recovery Rates: Lessons from Year One of IAPT. Behaviour Research and Therapy, 51, 597-606. https://doi.org/10.1016/j.brat.2013.06.004
Hearon, B. A., Quatromoni, P. A., Mascoop, J. L., & Otto, M. W. (2014). The Role of Anxiety Sensitivity in Daily Physical Activity and Eating Behavior. Eating Behaviors, 15, 255-258. https://doi.org/10.1016/j.eatbeh.2014.03.007
Horenstein, A., & Heimberg, R. G. (2020). Anxiety Disorders and Healthcare Utilization: A Systematic Review. Clinical Psychology Review, 81, Article ID: 101894. https://doi.org/10.1016/j.cpr.2020.101894
Kessler, K. C., Ruscio, A. M., Shear, K., & Wittchen, H. U. (2010). Epidemiology of Anxiety Disorders. In M. B. Stein, & T. Steckler (Eds.), Behavioral Neurobiology of Anxiety and Its Treatments (pp. 21-35). Springer. https://doi.org/10.1007/7854_2009_9
Kirsch, D., & Gilula, M. (2007). CES in the Treatment of Insomnia: A Review and Meta-Analysis. Practical Pain Management, 7, 28-39.
Kirsch, T. B., Kuhn, J., Price, L. R., Marksberry, J., & Haltiwanger, S. G. (2019). A Novel Medical Device That Relieves Anxiety, Depression and Pain While Improving Sleep in a Population of Teachers. Journal of Depression and Anxiety, 8 , 334.
Locke, A. B., Kirst, N., & Shultz, C. G. (2015). Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician, 91, 617-624.
Martin, P. (2003). The Epidemiology of Anxiety Disorders: A Review. Di alogues in Clinical Neuroscience, 5, 281-298. https://doi.org/10.31887/DCNS.2003.5.3/pmartin
Merikangas, K. R., & Swanson, S. A. (2010). Comorbidity in Anxiety Disorders. In M. B. Stein, & T. Steckler (Eds.), Behavioral Neurobiology of Anxiety and Its Treatments (pp. 37-59). Springer. https://doi.org/10.1007/7854_2009_32
Michael, T., Zetsche, U., & Margraf, J. (2007). Epidemiology of Anxiety Disorders. Ps y chiatry, 6, 136-142. https://doi.org/10.1016/j.mppsy.2007.01.007
Mochcovitch, M. D., da Rocha Freire, R. C., Garcia, R. F., & Nardi, A. E. (2017). Can Long-Term Pharmacotherapy Prevent Relapses in Generalized Anxiety Disorder? A Systematic Review. Clinical Drug Investigation, 37, 737-743. https://doi.org/10.1007/s40261-017-0528-x
Morriss, R., Patel, S., Boutry, C., Patel, P., Guo, B., Briley, P. M., & Kai, J. (2023). Clinical Effectiveness of Active Alpha-Stim AID versus Sham Alpha-Stim AID in Major Depression in Primary Care in England (Alpha-Stim-D): A Multicentre, Parallel Group, Double-Blind, Randomised Controlled Trial. The Lancet Psychiatry, 10, 172-183. https://doi.org/10.1016/S2215-0366(23)00007-X
Morriss, R., Xydopoulos, G., Craven, M., Price, L., & Fordham, R. (2019). Clinical Effectiveness and Cost Minimisation Model of Alpha-Stim Cranial Electrotherapy Stimulation in Treatment-Seeking Patients with Moderate to Severe Generalised Anxiety Disorder. Journal of Affective Disorders, 253, 426-437. https://doi.org/10.1016/j.jad.2019.04.020
Muntingh, A. D., van der Feltz-Cornelis, C. M., van Marwijk, H. W., Spinhoven, P., & van Balkom, A. J. (2016). Collaborative Care for Anxiety Disorders in Primary Care: A Systematic Review and Meta-Analysis. BMC Family Practice, 17, Article No. 62. https://doi.org/10.1186/s12875-016-0466-3
Nardone, R., Höller, Y., Leis, S., Höller, P., Thomschewski, A., Golaszewski, S., Brigo, F., & Trinka, E. (2014). Invasive and Non-Invasive Brain Stimulation for Treatment of Neuropathic Pain in Patients with Spinal Cord Injury: A Review. Journal of Spinal Cord Medicine, 37, 19-31. https://doi.org/10.1179/2045772313Y.0000000140
NHS England (2021). Social Prescribing . NHS England. https://www.england.nhs.uk/personalisedcare/social-prescribing/
NICE (2019a). Benzodiazepine and z-Drug Withdrawal . https://cks.nice.org.uk/topics/benzodiazepine-z-drug-withdrawal/
NICE (2019b). Generalised Anxiety Disorder and Panic Disorder in Adult s: Management. Clinical Guideline [CG113] . https://www.nice.org.uk/guidance/cg113
NICE (2021). Alpha-Stim AID for Anxiety Disorders. Medical Technologie s Guidance . https://www.nice.org.uk/guidance/mtg56
Patel, P., Boutry, C., Dalby, A., Butler, D., Higton, F., McNaughton, R., Morriss, P. R., & Patel, S. (2023). A Qualitative Exploration of Participant Experiences of Using Alpha-Stim AID for the Treatment of Moderate Severity Depressive Symptoms in Primary Care. P sychiatry Research Communications, 3 , Article ID: 100143. https://doi.org/10.1016/j.psycom.2023.100143
Pilkington, K., Loef, M., Polley, M., Simmons, R., & Portillo, M. C. (2017) Searching for Real-World Effectiveness of Health Care Innovations: Scoping Study of Social Prescribing for Diabetes. Journal of Medical Internet Research, 19, e20. https://doi.org/10.2196/jmir.6431
Robson Jr., J. P., & Troutman-Jordan, M. (2014). A Concept Analysis of Cognitive Reframing. Journal of Theory Construction & Testing, 18, 55-59.
Royal, S., Keeling, S., Kelsall, N., Price, L., Fordham, R., Xydopoulos, G., Dawson, G. R., Kingslake, J., & Morriss, R. (2022). Feasibility, Acceptability and Costs of Nurse-Led Alpha-Stim Cranial Electrostimulation to Treat Anxiety and Depression in University Students. BMC Primary Care, 23 , Article No. 97. https://doi.org/10.1186/s12875-022-01681-3
Sareen, J., Cox, B. J., Clara, I., & Asmundson, G. J. (2005). The Relationship between Anxiety Disorders and Physical Disorders in the US National Comorbidity Survey. Depression and Anxiety, 21, 193-202. https://doi.org/10.1002/da.20072
Schroeder, M. J., & Barr, R. E. (2001). Quantitative Analysis of the Electroencephalogram during Cranial Electrotherapy Stimulation. Clinical Neur ophysiology , 112 , 2075-2083. https://doi.org/10.1016/S1388-2457(01)00657-5
Shalaby, R. A. H., & Agyapong, V. I. O. (2020). Peer Support in Mental Health: Literature Review. JM IR Mental Health , 7, e15572. https://mental.jmir.org/2020/6/e15572 https://doi.org/10.2196/15572
Shekelle, P. G., Cook, I. A., Miake-Lye, I. M., Booth, M. S., Beroes, J. M., & Mak, S. (2018). Benefits and Harms of Cranial Electrical Stimulation for Chronic Painful Conditions, Depression, Anxiety, and Insomnia. Annals of Internal Medicine, 168, 414-421. https://doi.org/10.7326/M17-1970
Shenton, A. K. (2004). Strategies for Ensuring Trustworthiness in Qualitative Research Projects. Education for Information, 22, 63-75. https://doi.org/10.3233/EFI-2004-22201
Silverman, D. (2000). Doing Qualitative Research: A Practical Handboo k . Sage.
Silverman, D. (2015). Interpreting Qualitative Analysis . Sage.
Sundbom, L. T., & Bingefors, K. (2013). The Influence of Symptoms of Anxiety and Depression on Medication Nonadherence and Its Causes: A Population-Based Survey of Prescription Drug Users in Sweden. Patient Preference and Adherence, 19, 805-811. https://doi.org/10.2147/PPA.S50055
Toledo-Chávarri, A., Ramos-García, V., Torres-Castaño, A., Trujillo-Martín, M. M., Peñate Castro, W., Cura-Castro, D., Pedro Serrano-Aguilar, P., & Perestelo-Pérez, L. (2020). Framing the Process in the Implementation of Care for People with Generalized Anxiety Disorder in Primary Care: A Qualitative Evidence Synthesis. BMC Family Practice, 21, Article No. 237. https://doi.org/10.1186/s12875-020-01307-6
Wagenseil, B., Garcia, C., Suvorov, A. V., Fietze, I., & Penzel, T. (2018). The Effect of Cranial Electrotherapy Stimulation on Sleep in Healthy Women. Physiological Mea s urement, 39 , Article ID: 114007. https://doi.org/10.1088/1361-6579/aaeafa
Willig, C. (2001). Introducing Qualitative Research in Psychology Adve ntures in Theory and Method . Open University Press.
Willig, C. (2012). Perspectives on the Epistemological Bases for Qualitative Research. In H. Cooper (Ed.), The Handbook of Research Methods in Psychology (pp. 1-17). American Psychological Association. https://doi.org/10.1037/13619-002
Wittchen, H. U., & Hoyer, J. (2001). Generalized Anxiety Disorder: Nature and Course. Journal of Clinical Psychiatry, 62, 15-21.
Wittchen, H. U., Kessler, R. C., Beesdo, K., Krause, P., & Hoyer, J. (2002). Generalized Anxiety and Depression in Primary Care: Prevalence, Recognition, and Management. The Journal of Clinical Psychiatry, 63, 7712.
Xing, S., Dipaula, B. A., Lee, H. Y., & Cooke, C. E. (2011). Failure to Fill Electronically Prescribed Antidepressant Medications: A Retrospective Study. The Primary Care Co mpanion for CNS Disorders , 13 , 26352. https://doi.org/10.4088/PCC.10m00998blu
Zaghi, S., Acar, M., Hultgren, B., Boggio, P. S., & Fregni, F. (2010). Noninvasive Brain Stimulation with Low-Intensity Electrical Currents: Putative Mechanisms of Action for Direct and Alternating Current Stimulation. The Neuroscientist , 16 , 285-307. https://doi.org/10.1177/1073858409336227