Evaluating a Collaborative Care Model for the Treatment of Schizophrenia (EQUIP)

This study has been completed.
Sponsor:
Collaborators:
University of California, Los Angeles
asd
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00119574
First received: July 1, 2005
Last updated: October 25, 2013
Last verified: July 2005
  Purpose

Policy makers and consumers are increasingly concerned about the quality and efficiency of care provided to individuals with severe, chronic illnesses such as schizophrenia. These illnesses are expensive to treat and present significant challenges to organizations that are responsible for providing effective care. Occurring in 1% of the United States population, schizophrenia accounts for 10% of permanently disabled people, and 2.5% of all healthcare expenditures. Clinical practice guidelines have been promulgated. Schizophrenia is treatable and outcomes can be substantially improved with the appropriate use of antipsychotic medication, caregiver education and counseling, vocational rehabilitation, and assertive treatment. However, in the VA and other mental health systems, many patients with schizophrenia receive substandard care. Methods are needed that improve the quality of usual care for this disorder while being feasible to implement at typical clinics.

To date, most efforts to improve care for schizophrenia have focused on educating clinicians or changing the financing of care, and have had limited success. We believe a more fundamental approach should be tried. While there are many potential strategies, experience in chronic medical illness and mental health support the efficacy of specific approaches. Collaborative care models are one such approach. They are a blueprint for reorganizing practice, and involve changes in division of labor and responsibility, adoption of new care protocols, and increased attention to patients' needs. Although collaborative care models have been successful in other chronic medical conditions, they have not yet been studied in the treatment of schizophrenia.

We have developed a collaborative care model for schizophrenia that builds on work in other disorders, and includes service delivery approaches that are known to be effective in schizophrenia. The model focuses on improving treatment through assertive care management, caregiver education and support, and standardized patient assessment with feedback of information to psychiatrists. This project, "EQUIP" (Enhancing Quality Utilization In Psychosis) is implementing collaborative care and evaluating its effectiveness in schizophrenia.


Condition Intervention
Schizophrenia Disorders
Chronic Illness
Schizoaffective Disorder
Weight Gain
Procedure: Collaborative Chronic Illness Model

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Factorial Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Evaluating a Collaborative Care Model for the Treatment of Schizophrenia (EQUIP)

Resource links provided by NLM:


Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • At 15 mo.: Provider attitudes on controlling symptoms & side-effects, & on family involvement Patient clinical outcomes Throughout the study: Patient compliance Provider practice patterns & adherence to VA guidelines Patient utilization [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Process assessment throughout the course of the study of barriers and facilitators to the intervention�s implementation [ Designated as safety issue: No ]

Estimated Enrollment: 443
Study Start Date: January 2002
Study Completion Date: December 2004
Arms Assigned Interventions
Arm 1 Procedure: Collaborative Chronic Illness Model

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Providers (Psychiatrists, Case Managers, Nurses):

Working at one of the participating VA Mental Health Clinics

Providers: 68 Patients: 375

Patients:

  • At least 18 years old
  • Diagnosis of Schizophrenia, Schizoaffective, or schizophreniform disorder
  • At least 2 treatment visits with a psychiatrist at the clinic during the previous 6 months.

Exclusion Criteria:

None

  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00119574

Locations
United States, California
VA Greater Los Angeles Health Care System
West Los Angeles, California, United States, 90073
Sponsors and Collaborators
University of California, Los Angeles
asd
Investigators
Principal Investigator: Alexander S. Young, MD MSHS VA Greater Los Angeles Health Care System
  More Information

Additional Information:
Publications:
Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00119574     History of Changes
Other Study ID Numbers: CPI 99-383, RCD 00-033, NIMH MH-5423, NIMH MH-068639
Study First Received: July 1, 2005
Last Updated: October 25, 2013
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Randomized Controlled Trial
Quality of Health Care
Health Services Research
Guidelines
Medical Informatics Computing
Services, Mental Health
Medicine, Evidence-Based
Quality Assurance, Healthcare
Quality Indicators, Health Care
Veterans

Additional relevant MeSH terms:
Chronic Disease
Psychotic Disorders
Schizophrenia
Weight Gain
Disease Attributes
Pathologic Processes
Schizophrenia and Disorders with Psychotic Features
Mental Disorders
Body Weight Changes
Body Weight
Signs and Symptoms

ClinicalTrials.gov processed this record on July 22, 2014