Reducing Hospital Readmissions in Patients With Depressive Symptoms

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

709 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-02-28

Study Completion Date

2018-02-28

Brief Summary

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Project Re-Engineered Discharge (Project RED) has previously demonstrated that patients who received the RED were 30% less likely than patients receiving usual care to access inpatient or emergency services within 30 days of discharge. In this project, the investigators add a new dimension to RED by integrating screening, referral and treatment for depression into the original RED intervention and determining if this enhanced intervention increases the effectiveness of RED in preventing readmissions and controlling costs in the 180 days after discharge for patients with signs of depression.

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Detailed Description

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Conditions

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Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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RED-D Care Management

Patients randomized to receive the Intervention work with a RED-D Care Manager post-discharge. The Care Manager meets with the patient in the hospital, prior to discharge, and post-discharge via weekly phone calls. Patients have access to a range of treatment options, overseen by the Care Manager, including: (1) medication; (2) cognitive behavioral therapy (CBT); (3) complementary and alternative medicine (CAM) information and referral; (4) Self-help, such as reading a book, making a change in diet and/or exercise in order to improve mood; (5) active surveillance; and (6) any combination of 1, 2, 3, 4 \& 5.

Group Type EXPERIMENTAL

RED-D Care Management

Intervention Type OTHER

The Case Management intervention will continue for 12 weeks post-discharge (from the index admission).

RED and Behavioral Health Referral

Patients randomized to the "control" group will receive the regular RED intervention, including a follow-up phone call two days post-discharge from the hospital to review and confirm medications, and a referral to behavioral health.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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RED-D Care Management

The Case Management intervention will continue for 12 weeks post-discharge (from the index admission).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Over 18 years of age
* Admitted to any Boston Medical Center inpatient service or for observation
* Screen positive for depressive symptoms (Patient Health Questionnaire - 2 \>/= 3)
* Speaks English with health care providers
* Has access to a telephone
* Live in the Boston area and don't plan on leaving the Boston area for more than 2 weeks in the next 6 months
* Screen positive for depressive symptoms (PHQ -9 \>/= 10)

Exclusion Criteria

* Has plans for inpatient rehabilitation, nursing home, or other institutional settings after discharge.
* Suicidal precautions
* Sickle Cell Crisis (SCC)
* Alcohol and/or drug dependence
* Diagnosis of Bipolar Disorder, Schizophrenia or other Psychotic Disorder
* In police custody

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No