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Improving Depression Treatment for Older Minority Adults
This study has been completed.
Study NCT00570427   Information provided by National Institute on Aging (NIA)
First Received: December 7, 2007   Last Updated: February 24, 2009   History of Changes

December 7, 2007
February 24, 2009
February 2007
June 2008   (final data collection date for primary outcome measure)
Depression severity, depression treatment preferences, and barriers to care [ Time Frame: baseline and 6 months ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00570427 on ClinicalTrials.gov Archive Site
Feasibility, acceptability, and effectiveness of intervention [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Same as current
 
Improving Depression Treatment for Older Minority Adults
Improving Depression Treatment for Older Minority Adults

The purpose of this study is to improve access to quality depression care for older, low-income, minority adults in public sector health care. The study will examine current depression care in a public sector geriatric clinic that serves mostly Spanish-speaking Latinos and pilot study assessments and treatments in order to lay the groundwork for a large study of quality improvement for depressed older minorities

Depressive disorders affect 5-10% of older primary care patients, although rates may be higher among Latinos, especially among immigrants and those less acculturated. Late-life depression may be chronic and recurrent and results in significant morbidity and mortality. Despite a growing evidence base for the treatment of geriatric depression, only half of depressed older adults receive mental health care; fewer than 10% receive specialty services. Treatment rates are even lower for low-income, ethnic minorities who may be more ill and disabled, may lack adequate insurance and have different treatment preferences, and who frequently face barriers to accessing care. Recent quality improvement interventions for geriatric depression have targeted primary care, the location where older patients and ethnic minorities are most likely to receive mental health services. A recent multi-site, randomized trial of collaborative care for geriatric depression in primary care offered patients their choice of treatments, including antidepressant medication or 6-8 sessions of a structured psychotherapy. Although the intervention had few cultural accommodations, both processes and outcomes of care improved for depressed older minorities. However, because the study only included Latinos who were English-speaking and mostly high school graduates, these results may not generalize to a large proportion of ethnic minorities.

This study first examines current rates of depression and patterns of depression treatment in a public-sector geriatric clinic that serves mostly Spanish-speaking Latinos. Then depressed patients are identified and their depression treatment preferences and barriers to care are assessed. Patients are enrolled in a 6-month patient-centered, evidence-based intervention, and they, family members, and clinic medical providers are interviewed at program end to assess the feasibility, acceptability, and possible effectiveness of the intervention.

 
Interventional
Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study
Depression
  • Behavioral: Problem Solving Therapy (PST)
  • Behavioral: Medication Management
Experimental: All participants

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Completed
30
June 2008
June 2008   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients of the LAC+USC Medical Center Geriatric Clinic
  • English- or Spanish-speaking
  • Positive for depression on the Geriatric Depression Scale
  • Current major depressive disorder or dysthymia
  • All adult family members, especially caregivers, and all regular clinic providers eligible for interviews

Exclusion Criteria:

  • History of bipolar disorder or psychosis
  • Significant cognitive impairment (score less than 24 on the Mini-Mental Status Examination, adjusted for age and education)
  • Acute suicidal ideation
Both
60 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00570427
Isabel T. Lagomasino, MD MSHS, Keck School of Medicine, University of Southern California
AG0091, 5P30 AG021684, 1557 G GD102
National Institute on Aging (NIA)
UCLA Resource Centers for Minority Aging Research/Center for Health Improvement of Minority Elderly (RCMAR/CHIME)
Principal Investigator: Isabel T. Lagomasino, MD MSHS Department of Psychiatry, Keck School of Medicine, University of Southern California
National Institute on Aging (NIA)
February 2009

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