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| Descriptive Information Fields | |||||
| Brief Title † | Improving Depression Treatment for Older Minority Adults | ||||
| Official Title † | Improving Depression Treatment for Older Minority Adults | ||||
| Brief Summary | 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 |
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| Detailed Description | 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. |
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| Study Phase | |||||
| Study Type † | Interventional | ||||
| Study Design † | Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study | ||||
| Primary Outcome Measure † | Depression severity, depression treatment preferences, and barriers to care [ Time Frame: baseline and 6 months ] [ Designated as safety issue: No ] | ||||
| Secondary Outcome Measure † | Feasibility, acceptability, and effectiveness of intervention [ Time Frame: 6 months ] [ Designated as safety issue: No ] | ||||
| Condition † | Depression | ||||
| Intervention † | Behavioral: Problem Solving Therapy (PST) Behavioral: Medication Management |
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| MEDLINE PMIDs | 17484933, 17325113, 16339612 | ||||
| Links | |||||
| Recruitment Information Fields | |||||
| Recruitment Status † | Recruiting | ||||
| Enrollment † | 30 | ||||
| Start Date † | February 2007 | ||||
| Completion Date | June 2008 | ||||
| Eligibility Criteria † | Inclusion Criteria:
Exclusion Criteria:
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| Gender | Both | ||||
| Ages | 60 Years and older | ||||
| Accepts Healthy Volunteers | No | ||||
| Contacts †† |
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| Location Countries † | United States | ||||
| Administrative Information Fields | |||||
| NCT ID † | NCT00570427 | ||||
| Organization ID | AG0091 | ||||
| Secondary IDs †† | 5P30 AG021684, 1557 G GD102 | ||||
| Study Sponsor † | National Institute on Aging (NIA) | ||||
| Collaborators †† | UCLA Resource Centers for Minority Aging Research/Center for Health Improvement of Minority Elderly (RCMAR/CHIME) | ||||
| Investigators † |
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| Information Provided By | National Institute on Aging (NIA) | ||||
| Verification Date | February 2008 | ||||
| First Received Date † | December 7, 2007 | ||||
| Last Updated Date | February 28, 2008 | ||||