A Collaborative Care Program to Improve Depression Treatment in Cardiac Patients
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Depression in cardiac patients is common, persistent, and deadly. However, the vast majority of cardiac patients with depression go unrecognized and untreated, despite the existence of treatments that clearly improve depressive symptoms and may favorably impact survival. Our research group and others have found that depression recognition and treatment appears particularly limited among patients with acute cardiac illness, though this population may be the most vulnerable to the deleterious effects of depression. We propose a project, building on successful collaborative care depression management programs in outpatient settings, to address this important issue.
The specific hypotheses behind the proposed research are that a collaborative care depression management program can be successfully adapted to inpatient cardiac units, and that such a program will lead to greater rates of adequate depression treatment and improvements in secondary outcomes.
The following specific aims capture the stepwise goals of this program:
- To determine whether a collaborative care depression management program ('Enhanced Care') leads to significantly increased rates of adequate depression treatment compared to usual care (screening and feedback) (Primary Aim).
- To assess whether this Enhanced Care program has a lasting impact on adequate depression treatment, depressive symptoms, health-related quality of life, and adherence to medical recommendations at 6 weeks, 12 weeks, and 6 months, compared to usual care.
Condition | Intervention |
---|---|
Coronary Artery Disease Congestive Heart Failure Arrhythmia Depression |
Behavioral: Collaborative care vs. usual care |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Health Services Research |
Official Title: | A Collaborative Care Program to Improve Depression Treatment in Cardiac Patients |
- Rates of adequate depression treatment at discharge [ Time Frame: hospital discharge ] [ Designated as safety issue: No ]
- Depressive symptoms [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Enrollment: | 175 |
Study Start Date: | July 2007 |
Study Completion Date: | June 2010 |
Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: Collaborative care
A study care manager provides depression education, consults with study psychiatrist to develop individualized treatment recommendations, and collaborates with patient and medical team to implement those recommendations
|
Behavioral: Collaborative care vs. usual care
depression education, treatment recommendations, coordination of care
|
Active Comparator: Usual care
Primary medical providers are informed that the patient has depression and that treatment is recommended.
|
Behavioral: Collaborative care vs. usual care
depression education, treatment recommendations, coordination of care
|
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Inpatient admission for cardiac diagnosis
- Positive depression evaluation (PHQ-2>2, PHQ-9>9)
- Ability to provide informed consent
Exclusion Criteria:
- Active suicidal ideation
- Bipolar disorder, psychotic disorder, active substance use disorder
United States, Massachusetts | |
Massachusetts General Hospital | |
Boston, Massachusetts, United States, 02114 |
Principal Investigator: | Jeff C Huffman, MD | Massachusetts General Hospital |
No publications provided by Massachusetts General Hospital
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Jeff C Huffman, MD, Massachusetts General Hospital |
ClinicalTrials.gov Identifier: | NCT00847132 History of Changes |
Other Study ID Numbers: | 2007P-001152 |
Study First Received: | February 17, 2009 |
Last Updated: | November 29, 2010 |
Health Authority: | United States: Institutional Review Board |
Keywords provided by Massachusetts General Hospital:
Collaborative Care |
Additional relevant MeSH terms:
Arrhythmias, Cardiac Coronary Artery Disease Myocardial Ischemia Coronary Disease Depression Depressive Disorder Heart Failure Heart Diseases |
Cardiovascular Diseases Pathologic Processes Arteriosclerosis Arterial Occlusive Diseases Vascular Diseases Behavioral Symptoms Mood Disorders Mental Disorders |
ClinicalTrials.gov processed this record on September 26, 2012