Implementing Effective, Collaborative Care for Schizophrenia (EQUIP-2) - Full Text View

Purpose

This project evaluates the the implementation and effectiveness of a care model to improve treatment for schizophrenia within the context of diverse VA practices and priorities. The project provides more information to VA clinicians and managers about veterans with schizophrenia or schizoaffective disorder who are overweight and/or who would like to return to competitive work. The project facilitates reorganization of care practices in order to get veterans needed and desired services around wellness and work. The project creates a platform that other clinical and research interventions can build upon to improve care, and is designed to inform a national strategy for implementing evidence-based care in schizophrenia.

Condition	Intervention
Schizophrenia Chronic Illness Unemployment Weight Gain Psychotic Disorder	Procedure: Collaborative Chronic Illness Care Model

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Factorial Assignment Masking: Open Label Primary Purpose: Health Services Research
Official Title:	Implementing Effective, Collaborative Care for Schizophrenia

Resource links provided by NLM:

MedlinePlus related topics: Coping with Chronic Illness Mental Disorders Psychotic Disorders Schizophrenia

U.S. FDA Resources

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:

Evaluate the effect of care model implementation on provider competencies, treatment appropriateness, patient outcomes and service utilization [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

Evaluate processes of and variations in care model implementation and effectiveness to strengthen the intervention and to assess acceptability, how strategies affect implementation and the impact of individual components on treatment appropriateness [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Identify facilitators and barriers to wellness program participation in an effort to strengthen the weight management services available to patients with schizophrenia [ Time Frame: 9 months ] [ Designated as safety issue: No ]

Enrollment:	1067
Study Start Date:	June 2007
Study Completion Date:	May 2011
Primary Completion Date:	March 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Arm 1 Collaborative Care Model (described below)	Procedure: Collaborative Chronic Illness Care Model A care model that integrates greater availability of clinical information, reorganizes the practice system and provider roles, fosters care coordination, and focuses on evidence-based protocols--specifically supported employment and wellness services for individuals with schizophrenia.
No Intervention: Arm 2 Usual Care

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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, Supported Employment workers Nutritionists, Local Recovery Coordinators, Quality Improvement experts) working at one of the participating VA Medical Centers

Patients:

At least 18 years old
Diagnosis of Schizophrenia, Schizoaffective, or schizophreniform disorder
At least 1 treatment visit with a clinician at the clinic during the 6 months prior to enrollment and then at least 1 treatment visit with a clinician at the clinic during the 5 months of enrollment.

Exclusion Criteria:

None

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00137280

Locations

United States, California
VA Long Beach Healthcare System, Long Beach, CA
Long Beach, California, United States, 90822
VA Greater Los Angeles Health Care System
West Los Angeles, California, United States, 90073
United States, Louisiana
VA Medical Center
Shreveport, Louisiana, United States, 71101
United States, Nevada
VA Southern Nevada Healthcare System, North Las Vegas, NV
Las Vegas, Nevada, United States, 89106
United States, New York
James J Peters VA Medical Center
Bronx, New York, United States, 10468
VA Medical Center, Northport
Northport, New York, United States, 11768
United States, Texas
Michael E DeBakey VA Medical Center
Houston, Texas, United States, 77030
Central Texas Veterans Health Care System
Temple, Texas, United States, 76504

Sponsors and Collaborators

Department of Veterans Affairs

UCLA-RAND NIMH Partnered Research Center for Quality Care

Investigators

Principal Investigator:

Alexander S. Young, MD MSHS

VA Greater Los Angeles Health Care System

More Information

Publications:

Young AS, Niv N, Chinman M, Dixon L, Eisen SV, Fischer EP, Smith J, Valenstein M, Marder SR, Owen RR. Routine outcomes monitoring to support improving care for schizophrenia: report from the VA Mental Health QUERI. Community Ment Health J. 2011 Apr;47(2):123-35. Epub 2010 Jul 25.

Cohen AN, Glynn SM, Hamilton AB, Young AS. Implementation of a family intervention for individuals with schizophrenia. J Gen Intern Med. 2010 Jan;25 Suppl 1:32-7.

Hamilton AB, Cohen AN, Young AS. Organizational readiness in specialty mental health care. J Gen Intern Med. 2010 Jan;25 Suppl 1:27-31.

Brown AH, Cohen AN, Chinman MJ, Kessler C, Young AS. EQUIP: Implementing chronic care principles and applying formative evaluation methods to improve care for schizophrenia: QUERI Series. Implement Sci. 2008 Feb 15;3:9.

Niv N, Shatkin JP, Hamilton AB, Unützer J, Klap R, Young AS. The Use of Herbal Medications and Dietary Supplements by People with Mental Illness. Community Ment Health J. 2009 Aug 18; [Epub ahead of print]

Young AS, Niv N, Cohen AN, Kessler C, McNagny K. The Appropriateness of Routine Medication Treatment for Schizophrenia. Schizophr Bull. 2008 Nov 7; [Epub ahead of print]

Young AS, Klap R, Shoai R, Wells KB. Persistent depression and anxiety in the United States: prevalence and quality of care. Psychiatr Serv. 2008 Dec;59(12):1391-8.

Cohen AN, Glynn SM, Murray-Swank AB, Barrio C, Fischer EP, McCutcheon SJ, Perlick DA, Rotondi AJ, Sayers SL, Sherman MD, Dixon LB. The family forum: directions for the implementation of family psychoeducation for severe mental illness. Psychiatr Serv. 2008 Jan;59(1):40-8.

Responsible Party:	Department of Veterans Affairs
ClinicalTrials.gov Identifier:	NCT00137280 History of Changes
Other Study ID Numbers:	MNT 03-213, P30MH082760
Study First Received:	August 25, 2005
Last Updated:	April 18, 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, Evidenced-Based
Quality Assurance, Healthcare
Quality Indicators, Health Care
Veterans

Additional relevant MeSH terms:

Chronic Disease
Psychotic Disorders
Mental Disorders
Schizophrenia
Weight Gain
Disease Attributes

Pathologic Processes
Schizophrenia and Disorders with Psychotic Features
Body Weight Changes
Body Weight
Signs and Symptoms

ClinicalTrials.gov processed this record on May 23, 2013