Partnership in Medication Management (PIMM) in Patients With Mood Disorders

NCT ID: NCT02285608

Last Updated: 2015-11-18

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

166 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-01-31

Study Completion Date

2017-05-31

Brief Summary

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Investigators are doing this study to examine if a new personalized education program for patients with mood disorders (depression and bipolar disorders) will help them take their medications as prescribed by doctors. Investigators will teach patients about how, when and why it is important for them to take their medications as prescribed. Also, investigators will ask patients why they do not take medications as prescribed. Furthermore, investigators will examine whether our education program might save money if it prevents problems related to not taking medication.

Detailed Description

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The efficacy of anti-depressants or lithium reported in clinical trials differs from clinical experience. Various factors such as non-adherence to treatment and poor tolerability to medications have been related to treatment non-response or treatment failure in mood disorders (major depressive disorder and bipolar disorder). Premature discontinuation of treatment for mood disorders is common. The long treatments, the patients' beliefs about medications, the lack of knowledge about the medication/treatment purpose, benefits, dosage, and side effects and the relationship between patient and healthcare providers affect treatment continuation.

Investigators are proposing a sequential explanatory mixed methods study to investigate a novel program for medication training in persons with mood disorders. The ultimate purpose of the program is to improve medication adherence in these persons. The primary component of the present study will be quantitative, i.e., a randomized controlled trial with 12 months of follow-up to examine the effect of one-on-one medication training, including the use of a checklist system, on medication adherence in patients with mood disorders. The training program will include education to improve patients' knowledge regarding their medication's purpose, dosage, benefits, and side effects. The program will also include tools like a checklist or alarm clock to remind patients of when and how to take their medication. Furthermore, the program will contain an interactive listening period where healthcare professionals involved in medication dispensing will listen to patients' concerns, questions and thoughts regarding their medications. To the best of the investigators' knowledge, no research has comprehensively examined whether one-on-one medication training, as described above, may improve medication adherence in patients with mood disorders.

Conditions

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Major Depressive Disorder Bipolar Disorder

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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PIMM/SAM

Partnership in Medication Management (PIMM): The nurse and the attending physician will meet with the patient and ask how s/he administers medication at home (i.e., blister pack). Initial education session: the nurse will teach the patient about his/her medications, dosage, purpose, when and how to take them. Nurse and patient will establish reminders to take his/her medication. Following the education session, patients will be required to notify the nurse when it is time to take their medications, where their medications are, dosage, purpose and side effects. Self-Administered Medication (SAM): Patients will transition to SAM once the clinical team feels that no further medication changes are required. SAM is also the model that the participants will follow after discharge.

Group Type EXPERIMENTAL

PIMM/SAM

Intervention Type OTHER

The PIMM program will include education to improve patients' knowledge regarding their medication's purpose, dosage, benefits, and side effects. The program will also include tools like a checklist or alarm clock to remind patients of when and how to take their medication. Furthermore, the program will contain an interactive listening period where healthcare professionals involved in medication dispensing will listen to patients' concerns, questions and thoughts regarding their medications.

Standard Prescribing Practice(SPP)

Standard prescribing practice (SPP): medication administration will proceed as standard practice. Patients will not receive a personalized medication training. The nurse will administer the patient's medications. However, patients are encouraged to ask any questions regarding his/her medications.Patients will not be provided with any tool to help them to remember when to take their medications. The nurse will record the patient's knowledge regarding his/her medications.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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PIMM/SAM

The PIMM program will include education to improve patients' knowledge regarding their medication's purpose, dosage, benefits, and side effects. The program will also include tools like a checklist or alarm clock to remind patients of when and how to take their medication. Furthermore, the program will contain an interactive listening period where healthcare professionals involved in medication dispensing will listen to patients' concerns, questions and thoughts regarding their medications.

Intervention Type OTHER

Other Intervention Names

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Partnership in Medication Management

Eligibility Criteria

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Inclusion Criteria

* admitted to the inpatient clinic of the Mood Disorders Program, St. Joseph's Healthcare Hamilton
* with a primary diagnosis of bipolar disorder I or II, or major depressive disorder
* able to speak, read, and understand English.

Exclusion Criteria

* cut off score on Montreal Cognitive Assessment (MOCA; clinical judgement)
* significant suicidal or homicidal risk
* a medical condition/treatment known to affect the brain
* acquired brain injury.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Joseph's Healthcare Hamilton

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Carolina Oremus, MD, PhD(c)

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Sharon Simmons, RN,BScN,CPMHNc

Role: PRINCIPAL_INVESTIGATOR

St. Joseph's Healthcare Hamilton

Margaret C McKinnon, PhD,C.Psych.

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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Mood Disorders Program, St. Joseph's Healthcare Hamilton

Hamilton, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Carolina Oremus, MD, PhD(c)

Role: CONTACT

+1(905) 522-1155 ext. 36326

Margaret C McKinnon, PhD,C.Psych.

Role: CONTACT

+1(905) 522-1155 ext. 35438

Facility Contacts

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Carolina Oremus, MD,PhD(c)

Role: primary

+1(905) 522-1155 ext. 36326

Margaret C McKinnon, PhD,C.Psych.

Role: backup

+1(905) 522-1155 ext. 36645

References

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The World Health Organization.The global burden of disease: 2004 update, Table A2: Burden of disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004. Geneva, Switzerland, 2008 (accessed on: March 6, 2014).

Reference Type BACKGROUND

Health Canada. A Report on Mental Illnesses in Canada. Ottawa: Health Canada, 2002.

Reference Type BACKGROUND

World Health Organization. Adherence to Long- Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization, 2003.

Reference Type BACKGROUND

Rosa AR, Marco M, Fachel JM, Kapczinski F, Stein AT, Barros HM. Correlation between drug treatment adherence and lithium treatment attitudes and knowledge by bipolar patients. Prog Neuropsychopharmacol Biol Psychiatry. 2007 Jan 30;31(1):217-24. doi: 10.1016/j.pnpbp.2006.08.007. Epub 2006 Sep 18.

Reference Type BACKGROUND
PMID: 16982121 (View on PubMed)

Nemeroff CB, Heim CM, Thase ME, Klein DN, Rush AJ, Schatzberg AF, Ninan PT, McCullough JP Jr, Weiss PM, Dunner DL, Rothbaum BO, Kornstein S, Keitner G, Keller MB. Differential responses to psychotherapy versus pharmacotherapy in patients with chronic forms of major depression and childhood trauma. Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):14293-6. doi: 10.1073/pnas.2336126100. Epub 2003 Nov 13.

Reference Type BACKGROUND
PMID: 14615578 (View on PubMed)

Other Identifiers

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PIMM Mood Disorders Program

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

PIMM MDP

Identifier Type: -

Identifier Source: org_study_id