Determining Depression Treatment Preferences of Low-Income Latinos in Primary Care Settings

NCT ID: NCT00260169

Last Updated: 2013-12-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

432 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-11-30

Study Completion Date

2009-01-31

Brief Summary

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This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos.

Detailed Description

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Depression is a serious illness that is difficult to diagnose and treat, especially in populations that underutilize mental health services. The Latino population is one such group. Accommodating patient preferences for care, provider capacities, and administrator priorities is essential to the development of effective depression care interventions that are sustainable in public sector systems. However, little is understood regarding the depression treatment preferences of low-income Latinos who have not received quality depression care and who may not feel that they can voice their opinions about their health care. In addition, little is known about the preferences, capabilities, and priorities of providers and administrators in primary care clinics. This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos. The study will also evaluate the effectiveness of various treatments in reducing depression.

Following baseline assessments of depression treatment preferences and resources, participants in this open label study will be randomly assigned to receive collaborative care either immediately or after a waiting period. Individuals assigned to receive immediate care will undergo treatment for 12 weeks. Other participants will receive treatment at a later time. All participants will have the option to receive one of the following treatments: (1) medication management from the Depression Care Specialist (DCS) and antidepressant medication from their primary care provider (PCP); (2) cognitive-behavioral therapy from the DCS; or (3) a combination of both treatments. Depression treatment outcomes and preferences will be measured post-intervention. Provider and administrator preferences will also be measured post-intervention and potential strategies for implementing patient-centered depression care programs will be identified.

Conditions

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Depression

Keywords

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Treatment Preferences Public sector Latino

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Participants will receive collaborative care

Group Type EXPERIMENTAL

Collaborative care treatment

Intervention Type BEHAVIORAL

Patients receiving collaborative care treatment choose 12 weeks of CBT and/or medication management (antidepressants prescribed by patients' primary care provider) from the study depression care specialist (DCS).

2

Participants will receive enhanced usual care

Group Type ACTIVE_COMPARATOR

Enhanced usual care

Intervention Type BEHAVIORAL

Usual care participants are assigned to a 16-week wait-list for the study treatment, during which they are free to receive treatment elsewhere. A letter is given to participants' primary care providers (PCP) that indicates they screened positive for depression. In addition, patients receive an information booklet about depression and a community resource list.

Interventions

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Collaborative care treatment

Patients receiving collaborative care treatment choose 12 weeks of CBT and/or medication management (antidepressants prescribed by patients' primary care provider) from the study depression care specialist (DCS).

Intervention Type BEHAVIORAL

Enhanced usual care

Usual care participants are assigned to a 16-week wait-list for the study treatment, during which they are free to receive treatment elsewhere. A letter is given to participants' primary care providers (PCP) that indicates they screened positive for depression. In addition, patients receive an information booklet about depression and a community resource list.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

For Participating Patients:

* Attending one of the study clinics for primary care
* English or Spanish-speaking
* Screens positive for major depressive disorder or dysthymia

For Providers:

* All primary care providers providing at least one day of services at one of the study clinics

For Administrators:

* Administrative, medical, and nursing directors from each study site and directors of affiliated local mental health clinics

Exclusion Criteria

For Participating Patients:

* Acutely suicidal
* Screens positive for bipolar disorder, psychotic disorder, or cognitive impairment
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

University of Southern California

OTHER

Sponsor Role lead

Responsible Party

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Isabel T. Lagomasino, MD, MSHS

Study Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Isabel T. Lagomasino, MD, MSHS

Role: PRINCIPAL_INVESTIGATOR

University of Southern California

Megan Dwight-Johnson, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

VA Medical Center-West Los Angeles

Locations

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H. Claude Hudson Comprehensive Health Center

Los Angeles, California, United States

Site Status

USC Family Practice Center at California Hospital

Los Angeles, California, United States

Site Status

LAC+USC Outpatient Department

Los Angeles, California, United States

Site Status

Countries

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United States

References

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Dwight-Johnson M, Lagomasino IT, Hay J, Zhang L, Tang L, Green JM, Duan N. Effectiveness of collaborative care in addressing depression treatment preferences among low-income Latinos. Psychiatr Serv. 2010 Nov;61(11):1112-8. doi: 10.1176/ps.2010.61.11.1112.

Reference Type RESULT
PMID: 21041350 (View on PubMed)

Other Identifiers

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R01MH067949

Identifier Type: NIH

Identifier Source: secondary_id

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DSIR 82-SEPC

Identifier Type: -

Identifier Source: secondary_id

R01MH067949

Identifier Type: NIH

Identifier Source: org_study_id

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