Trial Outcomes & Findings for Reducing Anxiety and Stress in Primary Care Patients (NCT NCT03794089)

NCT ID: NCT03794089

Last Updated: 2023-07-27

Results Overview

The primary outcome of anxiety symptom severity will be measured by the Generalized Anxiety Disorder-7 (GAD-7) self-report questionnaire, a validated measure that is widely used in VA primary care. Participants rate how much they have been bothered by each of 7 anxiety symptoms over the last 2 weeks on a Likert scale from 0 (not at all) to 3 (nearly every day). Scores are summed to create a total score ranging from 0 to 21 indicating severity of anxiety symptoms; higher scores indicate more severe symptoms. The total score is sensitive to change from treatment across the anxiety disorders. The GAD-7 has demonstrated reliability and validity and is a good screening tool for multiple anxiety disorders.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

35 participants

Primary outcome timeframe

Baseline & Post-Assessment (at 16 weeks)

Results posted on

2023-07-27

Participant Flow

Participants were adult (age 18 years or older) Veterans recruited from primary care clinics at the Syracuse VA Medical Center from April 2019 through October 2020. Eligible participants were identified through case finding from electronic medical records, direct referrals from primary care and behavioral health providers, or referrals from other local behavioral health research studies.

A telephone eligibility screening identified those eligible to participate in the study, based on study eligibility criteria including endorsing current anxiety anxiety symptoms and not already being in psychotherapy for anxiety/depression.

Participant milestones

Participant milestones
Measure
Brief Anxiety Intervention
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Overall Study
STARTED
17
18
Overall Study
Completed 4-week Assessment
16
18
Overall Study
Completed 8-week Assessment
14
18
Overall Study
Completed 12-week Assessment
13
17
Overall Study
COMPLETED
11
17
Overall Study
NOT COMPLETED
6
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Brief Anxiety Intervention
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Overall Study
Lost to Follow-up
4
1
Overall Study
Withdrawal by Subject
2
0

Baseline Characteristics

Reducing Anxiety and Stress in Primary Care Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Total
n=35 Participants
Total of all reporting groups
Age, Continuous
49.29 years
STANDARD_DEVIATION 15.76 • n=5 Participants
45.56 years
STANDARD_DEVIATION 16.88 • n=7 Participants
47.37 years
STANDARD_DEVIATION 16.21 • n=5 Participants
Sex: Female, Male
Female
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Sex: Female, Male
Male
15 Participants
n=5 Participants
15 Participants
n=7 Participants
30 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
15 Participants
n=5 Participants
16 Participants
n=7 Participants
31 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
3 Participants
n=5 Participants
0 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
White
11 Participants
n=5 Participants
16 Participants
n=7 Participants
27 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
0 Participants
n=7 Participants
3 Participants
n=5 Participants
Generalized Anxiety Disorder-7
12.76 scores on a scale
STANDARD_DEVIATION 4.41 • n=5 Participants
11.94 scores on a scale
STANDARD_DEVIATION 3.00 • n=7 Participants
12.34 scores on a scale
STANDARD_DEVIATION 3.72 • n=5 Participants
Patient Health Questionnaire-9
11.18 scores on a scale
STANDARD_DEVIATION 4.54 • n=5 Participants
10.78 scores on a scale
STANDARD_DEVIATION 5.08 • n=7 Participants
10.97 scores on a scale
STANDARD_DEVIATION 4.76 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline & Post-Assessment (at 16 weeks)

Population: Enrolled participants who completed Post-Assessment at 16 weeks

The primary outcome of anxiety symptom severity will be measured by the Generalized Anxiety Disorder-7 (GAD-7) self-report questionnaire, a validated measure that is widely used in VA primary care. Participants rate how much they have been bothered by each of 7 anxiety symptoms over the last 2 weeks on a Likert scale from 0 (not at all) to 3 (nearly every day). Scores are summed to create a total score ranging from 0 to 21 indicating severity of anxiety symptoms; higher scores indicate more severe symptoms. The total score is sensitive to change from treatment across the anxiety disorders. The GAD-7 has demonstrated reliability and validity and is a good screening tool for multiple anxiety disorders.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=11 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=17 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Generalized Anxiety Disorder-7 at Post-Assessment
GAD-7 total at Baseline
12.5 score on a scale
Standard Deviation 4.2
12.0 score on a scale
Standard Deviation 3.1
Generalized Anxiety Disorder-7 at Post-Assessment
GAD-7 total at Post (16 weeks)
4.6 score on a scale
Standard Deviation 5.2
9.1 score on a scale
Standard Deviation 5.2

SECONDARY outcome

Timeframe: Baseline & Post-Assessment (at 16 weeks)

Population: Enrolled Participants who completed Post-Assessment at 16 weeks

The secondary outcome of depressive symptom severity will be measured by the Patient Health Questionnaire-9 (PHQ-9) self-report questionnaire, a validated measure that is widely used in VA primary care. Participants rate how often they have been bothered by each of 9 symptoms over the last 2 weeks on a Likert scale from 0 (not at all) to 3 (nearly every day). Scores are summed to create a total score from 0 to 27 indicating severity of depressive symptoms; higher scores indicate greater severity. The total score is sensitive to change from treatment. The PHQ-9 has demonstrated reliability and validity.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=11 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=17 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Patient Health Questionnaire-9 at Post-Assessment
PHQ-9 total at Baseline
10.5 score on a scale
Standard Deviation 5.0
10.8 score on a scale
Standard Deviation 5.2
Patient Health Questionnaire-9 at Post-Assessment
PHQ-9 total at Post (16 weeks)
5.1 score on a scale
Standard Deviation 4.7
7.6 score on a scale
Standard Deviation 6.4

SECONDARY outcome

Timeframe: Baseline, 4 weeks, 8 weeks, 12 weeks, & Post-Assessment (at 16 weeks)

Population: Enrolled participants who completed each assessment

The secondary outcome of anxiety symptoms will be measured with the Depression Anxiety Stress Scale-21 (DASS-21) Anxiety Subscale. Participants indicate how much each of 7 items applies to them over the past week on a scale from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). Scores are summed and multiplied by 2 to create a total score ranging from 0 to 42; higher scores indicate higher anxiety symptoms. This measure has good psychometric properties in both clinical and non-clinical samples. The DASS-21 reliably distinguishes between symptoms of anxiety (panic/worry), stress (tension/agitation), and depression (low mood/anhedonia), which are highly comorbid.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Depression Anxiety Stress Scale-21 Anxiety Subscale Change
DASS-21 Anxiety subscale total at Baseline
12.4 score on a scale
Standard Deviation 9.4
10.1 score on a scale
Standard Deviation 9.5
Depression Anxiety Stress Scale-21 Anxiety Subscale Change
DASS-21 Anxiety subscale total at 4 weeks
10.4 score on a scale
Standard Deviation 7.3
9.4 score on a scale
Standard Deviation 8.3
Depression Anxiety Stress Scale-21 Anxiety Subscale Change
DASS-21 Anxiety subscale total at 8 weeks
7.0 score on a scale
Standard Deviation 6.3
10.1 score on a scale
Standard Deviation 8.6
Depression Anxiety Stress Scale-21 Anxiety Subscale Change
DASS-21 Anxiety subscale total at 12 weeks
4.8 score on a scale
Standard Deviation 4.7
9.9 score on a scale
Standard Deviation 7.4
Depression Anxiety Stress Scale-21 Anxiety Subscale Change
DASS-21 Anxiety subscale total at Post Assessment (16 weeks)
4.9 score on a scale
Standard Deviation 5.0
9.6 score on a scale
Standard Deviation 7.7

SECONDARY outcome

Timeframe: Baseline, 4 weeks, 8 weeks, 12 weeks, & Post-Assessment (at 16 weeks)

Population: Enrolled participants who completed each assessment

The secondary outcome of depression symptoms will be measured with the Depression Anxiety Stress Scale-21 (DASS-21) Depression Subscale. Participants indicate how much each of 7 items applies to them over the past week on a scale from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). Scores are summed and multiplied by 2 to create a total score ranging from 0 to 42; higher scores indicate higher depressive symptoms. This measure has good psychometric properties in both clinical and non-clinical samples. The DASS-21 reliably distinguishes between symptoms of anxiety (panic/worry), stress (tension/agitation), and depression (low mood/anhedonia) which are highly comorbid.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Depression Anxiety Stress Scale-21 Depression Subscale Change
DASS-21 Depression subscale total at Baseline
15.6 score on a scale
Standard Deviation 9.9
12.2 score on a scale
Standard Deviation 9.5
Depression Anxiety Stress Scale-21 Depression Subscale Change
DASS-21 Depression subscale total at 4 weeks
8.1 score on a scale
Standard Deviation 5.6
11.1 score on a scale
Standard Deviation 11.2
Depression Anxiety Stress Scale-21 Depression Subscale Change
DASS-21 Depression subscale total at 8 weeks
6.0 score on a scale
Standard Deviation 4.8
11.9 score on a scale
Standard Deviation 9.6
Depression Anxiety Stress Scale-21 Depression Subscale Change
DASS-21 Depression subscale total at 12 weeks
4.5 score on a scale
Standard Deviation 4.3
10.8 score on a scale
Standard Deviation 10.8
Depression Anxiety Stress Scale-21 Depression Subscale Change
DASS-21 Depression subscale total at Post-assessment (16 weeks)
4.9 score on a scale
Standard Deviation 4.9
9.9 score on a scale
Standard Deviation 12.6

SECONDARY outcome

Timeframe: Baseline, 4 weeks, 8 weeks, 12 weeks, & Post-Assessment (at 16 weeks)

Population: Enrolled participants who completed each assessment

The secondary outcome of stress symptoms will be measured with the Depression Anxiety Stress Scale-21 (DASS-21) Stress Subscale. Participants indicate how much each of 7 items applies to them over the past week on a scale from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). Scores are summed and multiplied by 2 to create a total score ranging from 0 to 42; higher scores indicate higher stress symptoms. This measure has good psychometric properties in both clinical and non-clinical samples. The DASS-21 reliably distinguishes between symptoms of anxiety (panic/worry), stress (tension/agitation), and depression (low mood/anhedonia), which are highly comorbid.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Depression Anxiety Stress Scale-21 Stress Subscale Change
DASS-21 Stress subscale total at 12 weeks
10.5 score on a scale
Standard Deviation 8.0
16.4 score on a scale
Standard Deviation 11.0
Depression Anxiety Stress Scale-21 Stress Subscale Change
DASS-21 Stress subscale total at Post-assessment (16 weeks)
7.6 score on a scale
Standard Deviation 9.2
14.1 score on a scale
Standard Deviation 10.3
Depression Anxiety Stress Scale-21 Stress Subscale Change
DASS-21 Stress subscale total at Baseline
18.7 score on a scale
Standard Deviation 8.6
17.8 score on a scale
Standard Deviation 6.9
Depression Anxiety Stress Scale-21 Stress Subscale Change
DASS-21 Stress subscale total at 4 weeks
16.9 score on a scale
Standard Deviation 8.0
17.3 score on a scale
Standard Deviation 11.2
Depression Anxiety Stress Scale-21 Stress Subscale Change
DASS-21 Stress subscale total at 8 weeks
11.7 score on a scale
Standard Deviation 6.9
17.0 score on a scale
Standard Deviation 10.4

SECONDARY outcome

Timeframe: Baseline, 4 weeks, 8 weeks, 12 weeks, & Post-Assessment (at 16 weeks)

Population: Enrolled participants who completed each assessment

Functional impairment from anxiety symptoms will be measured using the Overall Anxiety Severity and Impairment Scale (OASIS), which measures symptom severity and functional impairment across anxiety disorders and subthreshold symptoms. The 5-item scale demonstrates reliability (Cronbach's alpha = .84 in primary care sample) and validity in primary care patients. Participants indicate the frequency and intensity of anxiety, level of avoidance, and interference with activities and social functioning on a Likert scale from 0 to 4. Scores are summed to create a total score ranging from 0 to 20; higher scores indicate greater symptom severity and functional impairment from anxiety.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Overall Anxiety Severity and Impairment Scale Change
OASIS total at Baseline
9.4 score on a scale
Standard Deviation 3.9
9.4 score on a scale
Standard Deviation 2.8
Overall Anxiety Severity and Impairment Scale Change
OASIS total at 4 weeks
6.2 score on a scale
Standard Deviation 3.3
8.2 score on a scale
Standard Deviation 3.8
Overall Anxiety Severity and Impairment Scale Change
OASIS total at 8 weeks
5.5 score on a scale
Standard Deviation 3.4
8.0 score on a scale
Standard Deviation 4.6
Overall Anxiety Severity and Impairment Scale Change
OASIS total at 12 weeks
4.8 score on a scale
Standard Deviation 3.7
8.2 score on a scale
Standard Deviation 4.0
Overall Anxiety Severity and Impairment Scale Change
OASIS total at Post-assessment (16 weeks)
4.1 score on a scale
Standard Deviation 3.8
7.4 score on a scale
Standard Deviation 3.8

SECONDARY outcome

Timeframe: Baseline, 4 weeks, 8 weeks, 12 weeks, & Post-Assessment (at 16 weeks)

Population: Enrolled participants who completed each assessment

Functional impairment from depressive symptoms will be measured using the Overall Depression Severity and Impairment Scale (ODSIS), which measures symptom severity and functional impairment across depressive disorders and subthreshold symptoms. Adapted from the OASIS to apply to depression, the 5-item scale demonstrates reliability (Cronbach's alpha = .92 in community sample of adults) and validity. Participants indicate the frequency and intensity of depressive symptoms, difficulty engaging in activities, and interference with work/school/home activities and social functioning on a Likert scale from 0 to 4. Scores are summed to create a total score ranging from 0 to 20; higher scores indicate greater symptom severity and functional impairment due to depression.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Overall Depression Severity and Impairment Scale Change
ODSIS total at Baseline
6.5 score on a scale
Standard Deviation 4.3
6.2 score on a scale
Standard Deviation 4.5
Overall Depression Severity and Impairment Scale Change
ODSIS total at 4 weeks
4.3 score on a scale
Standard Deviation 3.7
5.3 score on a scale
Standard Deviation 4.4
Overall Depression Severity and Impairment Scale Change
ODSIS total at 8 weeks
3.9 score on a scale
Standard Deviation 3.5
5.6 score on a scale
Standard Deviation 5.5
Overall Depression Severity and Impairment Scale Change
ODSIS total at 12 weeks
2.7 score on a scale
Standard Deviation 3.3
6.2 score on a scale
Standard Deviation 5.3
Overall Depression Severity and Impairment Scale Change
ODSIS total at Post-assessment (16 weeks)
3.0 score on a scale
Standard Deviation 3.7
5.0 score on a scale
Standard Deviation 4.8

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline & Post-Assessment (at 16 weeks)

Population: Enrolled Participants who completed Post-Assessment at 16 weeks

Quality of life will be measured using the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF), which measures overall enjoyment and satisfaction with various aspects of life. The 16-item scale is reliable (alpha = .86) and valid. Participants rate satisfaction with each domain on a Likert scale from 1 to 5. Scores for items 1-14 are summed to create a total score ranging from 14 to 70; higher scores indicate higher quality of life.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=11 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=17 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form at Post-Assessment
Q-LES-Q-SF total at Baseline
44.9 score on a scale
Standard Deviation 8.5
43.8 score on a scale
Standard Deviation 7.4
Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form at Post-Assessment
Q-LES-Q-SF total at Post (16 weeks)
49.9 score on a scale
Standard Deviation 8.1
48.7 score on a scale
Standard Deviation 10.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-assessment (16 weeks)

Population: All participants who enrolled in the study

This feasibility outcome measure is the number who attended one or more treatment sessions

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Engagement in Treatment
15 participants
13 participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-assessment (16 weeks)

Population: All participants enrolled in the study

This feasibility measure is the number of treatment sessions completed during the 16-week active treatment phase

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=17 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Number of Treatment Sessions Completed
4.7 sessions
Standard Deviation 2.2
1.8 sessions
Standard Deviation 1.6

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-assessment (at 16 weeks)

Population: All participants who completed the Post-assessment (at 16 weeks) and reported attending at least one treatment session

The acceptability outcome of treatment satisfaction was assessed using the 8-item version of the Client Satisfaction Questionnaire. This self-report questionnaire has evidence of reliability and validity. Participants indicate their agreement with 8 items on a 4-point Likert scale. Scores are summed to create a total score ranging from 8 to 32; higher scores indicate greater satisfaction with treatment.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=10 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=13 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Treatment Satisfaction
29.80 score on a scale
Standard Deviation 2.82
24.23 score on a scale
Standard Deviation 5.69

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-assessment (16 weeks)

Population: All participants who completed the Post-assessment (at 16 weeks) and reported attending at least one treatment session

The acceptability outcome of treatment credibility was measured using a 4-item adapted version of the Expectancy Rating Scale, which asks patients to rate, on a Likert scale from 0 (not at all) to 10 (extremely), how logical this type of anxiety treatment seems, how confident they are that the treatment would eliminate anxiety, how confident they would be in recommending the treatment to a friend with anxiety, and how much improvement they expect to result from it. Scores are summed to create a total score ranging from 0 to 40; higher scores indicate greater treatment credibility.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=10 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=13 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Treatment Credibility
34.20 score on a scale
Standard Deviation 5.51
22.31 score on a scale
Standard Deviation 11.49

OTHER_PRE_SPECIFIED outcome

Timeframe: Post-assessment (16 weeks)

Population: All participants who completed Post-assessment (16 weeks) and reported attending at least one treatment session

The acceptability outcome of therapeutic alliance was measured using the 12-item Working Alliance Inventory-Short Form Revised, which asks patients to rate, on a Likert scale from 1 (seldom) to 5 (always), their experience of the therapist in terms of quality of the relationship bond, agreement on the goals of treatment, and agreement on the tasks of treatment. Scores are summed to create a total score ranging from 12 to 60. This measure has good reliability and validity.

Outcome measures

Outcome measures
Measure
Brief Anxiety Intervention
n=10 Participants
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=13 Participants
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Therapeutic Alliance
55.00 score on a scale
Standard Deviation 5.54
42.62 score on a scale
Standard Deviation 9.73

Adverse Events

Brief Anxiety Intervention

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Usual PC-MHI Care

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Brief Anxiety Intervention
n=17 participants at risk
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 participants at risk
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Cardiac disorders
Hospitalization
0.00%
0/17 • Adverse event data were collected over the course of a participant's study participation, 16 weeks.
n/a (same definitions as clinicaltrials.gov). Adverse event collection included systematic assessment (e.g., anxiety and depressive symptoms assessed at each treatment session in intervention condition and at each study assessment) and non-systematic assessment (e.g., participant self-report, information in participant medical record).
5.6%
1/18 • Number of events 1 • Adverse event data were collected over the course of a participant's study participation, 16 weeks.
n/a (same definitions as clinicaltrials.gov). Adverse event collection included systematic assessment (e.g., anxiety and depressive symptoms assessed at each treatment session in intervention condition and at each study assessment) and non-systematic assessment (e.g., participant self-report, information in participant medical record).

Other adverse events

Other adverse events
Measure
Brief Anxiety Intervention
n=17 participants at risk
Modular anxiety intervention designed for PC-MHI, up to six 30-minute sessions occurring approximately every 2 weeks, patients select modules of interest to them to complete, emphasis on psycho-education and cognitive-behavioral coping strategies for self-management Brief anxiety intervention: Modular anxiety intervention, tailored for Veterans, with emphasis on adaptive coping skills
Usual PC-MHI Care
n=18 participants at risk
Appointment with PC-MHI provider at local primary care clinic, providers delivers whatever interventions they deem appropriate and collaboratively decides with patients whether and when to meet again as in routine PC-MHI care Usual PC-MHI care: Anxiety treatment with mental health provider in local primary care clinic
Social circumstances
Symptom exacerbation
5.9%
1/17 • Number of events 1 • Adverse event data were collected over the course of a participant's study participation, 16 weeks.
n/a (same definitions as clinicaltrials.gov). Adverse event collection included systematic assessment (e.g., anxiety and depressive symptoms assessed at each treatment session in intervention condition and at each study assessment) and non-systematic assessment (e.g., participant self-report, information in participant medical record).
0.00%
0/18 • Adverse event data were collected over the course of a participant's study participation, 16 weeks.
n/a (same definitions as clinicaltrials.gov). Adverse event collection included systematic assessment (e.g., anxiety and depressive symptoms assessed at each treatment session in intervention condition and at each study assessment) and non-systematic assessment (e.g., participant self-report, information in participant medical record).

Additional Information

Dr. Robyn L. Shepardson

VA Center for Integrated Healthcare

Phone: 315-425-4400

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place