Electronic-Measurement Based Care for Major Depressive Disorder (e-MBC)
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Electronic-Measurement Based Care (e-MBC) for Major Depressive Disorder (MDD)|
- Patient Health Questionnaire (PHQ-9) [ Time Frame: Every 30 days for 6 months ]Depression severity assessment
- Frequency, Intensity, and Burden of Side Effect Rating (FIBSER) [ Time Frame: Every 30 days for 6 months ]Antidepressant side effects
- Patient Satisfaction Questionnaire (PSQ) [ Time Frame: At the end of study treament (6 months from the first assessment) ]Assesses satisfaction with care
- Physician Evaluation of Ease of Use Survey (EEUS) [ Time Frame: At the end of study treament (6 months from the first assessment) ]Physicians' perception of the ease of use of the e-MBC system
- Physician Evaluation of Usefulness Survey (EUS) [ Time Frame: At the end of study treament (6 months from the first assessment) ]Physicians' perception of the usefulness of the e-MBC system
|Study Start Date:||June 2011|
|Estimated Study Completion Date:||July 2013|
|Estimated Primary Completion Date:||July 2013 (Final data collection date for primary outcome measure)|
Active Comparator: e-MBC
Patients will receive e-MBC
Other Name: e-MBC for MDD
No Intervention: Treatment as Usual Control
Patients receive standard treatment
Major Depressive Disorder (MDD) is a serious, debilitating illness that affects persons of all ages, races, and socioeconomic backgrounds. Despite the availability of new and effective treatments over the last 20 years, recent evidence continues to demonstrate high rates of inadequate antidepressant medication treatment in practice settings. Practitioners vary widely in how they assess treatment outcomes, including symptoms, function, side-effect frequency and burden. In contrast to other chronic medical conditions such as diabetes mellitus, back/neck problems, or hypertension, clinicians treating patients with depression do not routinely evaluate measurement-based care (MBC) treatment parameters. MBC provides an essential framework for physicians to approach depression treatment consistent with their approach for other common disorders. MBC is an effective means to provide patient-centered care for MDD, personalizing treatment decisions based on patient progress and their ability to tolerate the medication.
A key barrier to patient adherence with MBC treatment is that the approach requires patients to return to the clinic for several follow-up visits. The necessity of treatment visits varies widely among patients. Thus far, physicians using MBC for the treatment of MDD do not have a complete set of tools that are practical to use and allow treatment to be truly personalized patient-centered care.
One solution to this problem is to use an enhanced electronic personal health record, such as the MyChart system. This system could be easily modified to include the central elements of MBC for depression to allow for the systematic assessment of a patient's depressive symptom severity, antidepressant tolerability, and adherence to treatment in a timely fashion. This information would be available to allow the physician to provide patient-centered care by utilizing standardized assessment to personalize treatment for depression. The proposed electronic-MBC (e-MBC) addresses a critical gap in depression treatment by providing regularly-scheduled drug monitoring and continuity of care, in the face of limited patient and clinic resources.
Information technology (IT) systems have been effectively integrated into the medical treatment of patients but have yet to have substantial impact at the point-of-care. Applying e-MBC methods allows physicians to utilize existing information technology systems to improve depression treatment at the point-of-care. The key features of the proposed e-MBC approach are that it can be seamlessly integrated into standard clinical practice, and requires no additional IT knowledge or training to be effectively utilized by physicians and clinical staff.
In this pilot study the investigators will compare standard treatment (office based antidepressant management) to a group receiving scheduled electronic MBC assessments via an enhanced personal health record system (e-MBC). To date, no one has published feasibility studies evaluating the use of personal health records for measurement-based care of depression patients.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01583998
|United States, Texas|
|The University of Texas Southwestern Medical Center|
|Dallas, Texas, United States, 75390|
|Principal Investigator:||David W. Morris, Ph.D.||UTSouthwestern|
|Principal Investigator:||Jay B. Morrow, D.V.M.||UTSouthwestern|
|Study Director:||Jeff Kendall, Psy.D.||UTSouthwestern|
|Study Director:||Heidi Hamann, Ph.D.||UTSouthwestern|