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"Consultation Liaison and Integrated Care for COPD Patients With Psychiatric Co-Morbidity" (COPD_HSRG)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT01644916
Recruitment Status : Completed
First Posted : July 19, 2012
Last Update Posted : September 7, 2018
Sponsor:
Collaborators:
National University Hospital, Singapore
Singapore General Hospital
Alexandra Hospital, Singapore
St Luke's Hospital, Singapore
Changi General Hospital
Information provided by (Responsible Party):
A/Prof Ng Tze Pin, National University, Singapore

Brief Summary:

Chronic obstructive pulmonary disease (COPD) stands out among chronic diseases with its high and rising prevalence and mortality, poor quality of life, high re-hospitalization rates and societal burden of care. Current therapeutic and management practices are generally met with limited success. Research in recent years have highlighted the high level of psychiatric co-morbidity in COPD patients, and the major prognostic significance of anxiety/depression in COPD outcomes such as re-hospitalization, smoking cessation, quality of life, and survival. This suggests that addressing psychiatric and psycho-social aspects of care prominent in COPD patients may have strongly positive impact on outcomes, but the available evidence of effectiveness is limited.

The primary aim of the proposed research is to evaluate the effectiveness of a holistic disease management paradigm of psychiatric liaison consultation (CL) that integrates psychiatric and respiratory care to improve outcomes for COPD patients. This integrated psychiatric consultation liaison (IPCL) management paradigm includes the routine screening and structured collaborative care of anxiety and major depressive symptoms and depressive/anxiety disorder in COPD patients. We postulate that the IPCL care paradigm would reduce mood symptoms, increase smoking quit rates, reduce symptom burden and functional disability, and improve quality of life, while reducing rehospitalization, emergency department (ED) and unscheduled physician visits. A secondary aim is to evaluate its cost effectiveness by concurrently collecting resource utilization data.


Condition or disease Intervention/treatment Phase
Chronic Obstructive Pulmonary Disease Anxiety Depression Procedure: Integrated care Procedure: Usual control Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 295 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: "Consultation Liaison and Integrated Care for COPD Patients With Psychiatric Co-Morbidity"
Actual Study Start Date : August 2012
Actual Primary Completion Date : December 2017
Actual Study Completion Date : December 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anxiety

Arm Intervention/treatment
Usual control
Usual control will be provided with usual standard management of COPD and psychiatric comorbidities.
Procedure: Usual control
Usual control group will be provided with usual standard procedures for management of COPD and psychiatric comorbidities.

Integrated care
Integrated care will be provided with integrated care management.
Procedure: Integrated care
Integrated care will be provided with management of multifaceted group including, nurse educators, doctors, case manager and psychologists.
Other Name: IPCL




Primary Outcome Measures :
  1. HADS score [ Time Frame: over 12 months ]
    Anxiety and depression symptoms and diagnosis


Secondary Outcome Measures :
  1. Resource use and direct costs of care [ Time Frame: over 12 months ]
    Resource use include inpatient service use (No. of times hospitalized and total days in hospital) , outpatient service use (physician visits consisting of GP visits and specialist visits,) and medication use( usage of any or specific drug classes)and costs for resource use over 12 months



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Ages Eligible for Study:   55 Years to 90 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Inpatients and specialist outpatients from: NUHS, SGH, CGH, SLH and AH.
  • Clinical diagnosis of chronic obstructive pulmonary disease (COPD) based on history, physical examination, spirometry, measurement of arterial blood gases, and chest radiographs, that meets the criteria for COPD as defined in the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
  • COPD patients include cases of all grades of severity, and co-morbidity, without restriction.
  • Participants provide written informed consent.

Exclusion Criteria:

  • Known diagnosis of a psychiatric disorder that is under treatment.
  • Terminally ill COPD patients who are unable to complete baseline assessments.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01644916


Locations
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Singapore
National University Hospital System
Singapore, Singapore, 119228
Sponsors and Collaborators
National University, Singapore
National University Hospital, Singapore
Singapore General Hospital
Alexandra Hospital, Singapore
St Luke's Hospital, Singapore
Changi General Hospital
Investigators
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Principal Investigator: Ng T Pin, MD National University, Singapore
Additional Information:
Publications:
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Responsible Party: A/Prof Ng Tze Pin, Research Director, National University, Singapore
ClinicalTrials.gov Identifier: NCT01644916    
Other Study ID Numbers: COPD_HSRG_2010
First Posted: July 19, 2012    Key Record Dates
Last Update Posted: September 7, 2018
Last Verified: September 2018
Keywords provided by A/Prof Ng Tze Pin, National University, Singapore:
COPD
Integrated care
IPCL
Additional relevant MeSH terms:
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Lung Diseases, Obstructive
Pulmonary Disease, Chronic Obstructive
Lung Diseases
Respiratory Tract Diseases