Expanding and Testing VA Collaborative Care Models for Depression (ReTIDES)

This study has been withdrawn prior to enrollment.
(This study was withdrawn prior to enrollment.)
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00119028
First received: July 1, 2005
Last updated: April 23, 2012
Last verified: April 2012
  Purpose

Based on the published evidence, collaborative care for depression is both necessary and sufficient for improving care and outcomes for depressed patients in primary care settings. The Translating Initiatives in Depression into Effective Solutions (TIDES) project, upon which ReTIDES is based, developed a VA-adapted version of collaborative care through input from veterans, clinicians, and managers. The initial TIDES project resulted in a clinically stable and effective model as tested in seven primary care practices in three VISNs. This positive result provided the basis for spreading and sustaining the TIDES model and initiating the study of national implementation strategies and issues.


Condition Intervention
Major Depression
Post-Traumatic Stress Disorder
Procedure: Depression Care Quality Improvement Implementation

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Official Title: Expanding and Testing VA Collaborative Care Models for Depression

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Impact of the intervention on depression performance measure, and provider attitudes. Quality of life-patient satisfaction. [ Time Frame: 9/30/08 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Cost-effectiveness, system costs, tool kit development [ Time Frame: 9/30/08 ] [ Designated as safety issue: No ]

Enrollment: 0
Study Start Date: April 2005
Study Completion Date: October 2009
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm 1
Non-experimental QI intervention - No comparator
Procedure: Depression Care Quality Improvement Implementation
We will used a randomized design to evaluate long term (18-month) cost effectiveness of TIDES collaborative care in six intervention clinics with fully-implemented collaborative care compared to three matched and randomly-assigned usual care clinics. We used a non-randomized quasiexperimental design (untreated control group with pretest and posttest) to measure impacts on clinician performance, knowledge, and attitudes in 6 newly-implemented collaborative care intervention clinics compared to 6 matched usual care clinics

Detailed Description:

Background:

Based on the published evidence, collaborative care for depression is both necessary and sufficient for improving care and outcomes for depressed patients in primary care settings. The Translating Initiatives in Depression into Effective Solutions (TIDES) project, upon which ReTIDES is based, developed a VA-adapted version of collaborative care through input from veterans, clinicians, and managers. The initial TIDES project resulted in a clinically stable and effective model as tested in seven primary care practices in three VISNs. This positive result provided the basis for spreading and sustaining the TIDES model and initiating the study of national implementation strategies and issues.

Objectives:

The objective of this grant was to carry out preparatory steps toward national implementation, including developing and investigating TIDES sustainability and partnering and marketing strategies. The project supported VISNs as learning organizations in the area of depression care improvement, and ultimately aimed to support as many as 8% to 10% of veterans nationally in improving their health and quality of life. Preparatory steps included 1) development of easily disseminated tools, including CPRS decision support, panel monitoring, and care manager and team training materials, 2) national and local dissemination to support TIDES model sustainability and spread and 3) evaluation using tools that would assess not only the success of this project, but could be used for quality monitoring during roll-out.

Methods:

Tools: We used the Chronic Illness Care model and Evidence Based Quality Improvement methods to develop tools for disseminating TIDES to additional medical centers and practices in 3 TIDES VISNs and two medical centers (with 10 practices) in one additional VISN. These tools were then used for national implementation. Dissemination: We served as technical expert consultants by 1) carrying out national and regional training; 2) linking to national patient care services, employee education, and information technology methods and priorities; and 3) supporting evidence-based quality improvement in new sites.We organized these efforts through a national dissemination plan.

Evaluation: We developed and applied 1) formative evaluation tools; 2) fine-tuned performance measure tools based on electronic data, and applied in a non-randomized quasi-experimental design (untreated control group with pretest and posttest); 3) a web-based survey for primary care clinicians and 4) an innovative implementation cost assessment approach. We also used 5) qualitative information on the process of dissemination , including links to national resources and 6) a randomized design to evaluate long term (18-month) cost effectiveness of TIDES.

Status:

Completed.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

- Primary care providers at each participating site.

Exclusion Criteria:

- All providers not located at participating sites.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00119028

Locations
United States, California
Long Beach
Long Beach, California, United States, 90822
United States, Louisiana
VA Medical Center
Shreveport, Louisiana, United States, 71101
United States, Minnesota
VA Medical Center
Minneapolis, Minnesota, United States, 55417
St. Cloud VA Medical Center
St Cloud, Minnesota, United States, 56303
United States, Ohio
VA Medical Center, Cincinnati
Cincinnati, Ohio, United States, 45220
United States, Texas
Michael E DeBakey VA Medical Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
Investigators
Principal Investigator: Lisa V. Rubenstein, MD MSPH VA Greater Los Angeles Health Care System
  More Information

Publications:

Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00119028     History of Changes
Other Study ID Numbers: MNT 03-215, Project #0024, PCC # 2004-121657
Study First Received: July 1, 2005
Last Updated: April 23, 2012
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Quality Improvement
Cluster Randomized Trial
Care Model

Additional relevant MeSH terms:
Depression
Depressive Disorder
Stress Disorders, Post-Traumatic
Stress Disorders, Traumatic
Depressive Disorder, Major
Behavioral Symptoms
Mood Disorders
Mental Disorders
Anxiety Disorders

ClinicalTrials.gov processed this record on April 23, 2014