Evaluation Study of TIDES Depression Care Quality Improvement Intervention

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00105820
First received: March 16, 2005
Last updated: October 25, 2013
Last verified: February 2007

March 16, 2005
October 25, 2013
June 2003
Not Provided
At set time points the following will be measured: Recovery from depression Patient quality of life 1 year before and after: Clinic depression treatment utilization and costs [ Designated as safety issue: No ]
Not Provided
Complete list of historical versions of study NCT00105820 on ClinicalTrials.gov Archive Site
Adherence to appropriate treatment [ Designated as safety issue: No ]
Not Provided
Not Provided
Not Provided
 
Evaluation Study of TIDES Depression Care Quality Improvement Intervention
Well-being Among Veterans Enhancement Study (WAVES)

In spite of the impact on veteran�s health status and treatment cost, depression is under-diagnosed and under-treated. The goal of this study is to learn how to implement a previously tested, effective collaborative care model for improving the quality of depression care across multiple Veterans Integrated Service Networks (VISNs). To achieve this goal, we are conducting a randomized controlled trial of evidence-based quality improvement (EBQI), a dissemination method that relies on expert design and local implementation of evidence-based practice interventions. We hypothesize that EBQI will result in increased rates of assessment and appropriate management of depression. Results will be useful in designing realistic chronic care programs and performance measures for continuing care improvement.

Objectives: Our primary objective is to evaluate whether collaborative care EBQI results in increased rates of assessment and appropriate management of depression and decreased depressive symptomatology for veterans. Our secondary objective is to evaluate the effect of EBQI on organizational outcomes.

Methods: Three VISNs, 10, 16 and 23, are participating. Three primary care clinics within each VISN are randomized, two to the intervention and one to usual care, for a total of nine study sites. In the intervention clinics, VA leadership, assisted by study staff, tailor and implement a depression care program for patient assessment, patient self-management support, provider education, primary and mental health collaboration, and care management. The usual care clinics participate only in the evaluation. Patient recruitment is through a telephone interview. Patients who are at risk for major depression are recruited, 67 from each site. Patient outcomes including depression symptom severity on the PHQ-9 and the VA SF-12 are being assessed by telephone at six months post enrollment. Other outcome variables are adequacy of antidepressant trials, psychotherapy and specialty care visits, and treatment adherence. A utilization and cost analysis will be conducted. VISN and VAMC leadership are surveyed to assess organizational outcomes. Data is being collected through VA administrative databases, patient and staff interviews, and study records. Power calculations and data analysis planning reflect the clustered sample design.

Interventional
Not Provided
Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
  • Major Depression
  • PTSD
Procedure: System level depression care quality improvement
Arm 1
Intervention: Procedure: System level depression care quality improvement

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
750
March 2006
Not Provided

Inclusion Criteria:

  • Enrolled as a pt in the VA Healthcare System
  • screens positive for major depression
  • has a scheduled visit at a primary care site taking part in the study

Exclusion Criteria:

  • severe alcohol abuse
  • psychosis
  • dementia
  • acutely suicidal (at screening)
  • lack of access to or ability to use a phone
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00105820
MHI 99-375
No
Department of Veterans Affairs
Department of Veterans Affairs
Not Provided
Principal Investigator: Edmund F. Chaney, PhD VA Puget Sound Health Care System
Principal Investigator: Lisa V. Rubenstein, MD MSPH VA Greater Los Angeles Health Care System
Department of Veterans Affairs
February 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP