Trial Outcomes & Findings for Improving Depression Management (NCT NCT05050227)

NCT ID: NCT05050227

Last Updated: 2025-07-20

Results Overview

The Patient Health Questionnaire (PHQ-9) is a scale commonly used to measure and categorize depression symptoms. It is already administered as part of routine primary care at our study site. The minimum score is 0, the maximum is 27. A higher score indicates a worse outcome (i.e. more severe depression symptoms).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

57 participants

Primary outcome timeframe

3-months

Results posted on

2025-07-20

Participant Flow

Participant milestones

Participant milestones
Measure
cCBT Enhanced Collaborative Care
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Overall Study
STARTED
29
28
Overall Study
COMPLETED
21
21
Overall Study
NOT COMPLETED
8
7

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Improving Depression Management

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
cCBT Enhanced Collaborative Care
n=29 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=28 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Total
n=57 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
24 Participants
n=5 Participants
22 Participants
n=7 Participants
46 Participants
n=5 Participants
Age, Categorical
>=65 years
5 Participants
n=5 Participants
6 Participants
n=7 Participants
11 Participants
n=5 Participants
Age, Continuous
49.9 years
STANDARD_DEVIATION 17.6 • n=5 Participants
49.8 years
STANDARD_DEVIATION 15.1 • n=7 Participants
49.9 years
STANDARD_DEVIATION 16.3 • n=5 Participants
Sex: Female, Male
Female
8 Participants
n=5 Participants
9 Participants
n=7 Participants
17 Participants
n=5 Participants
Sex: Female, Male
Male
21 Participants
n=5 Participants
19 Participants
n=7 Participants
40 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
10 Participants
n=5 Participants
8 Participants
n=7 Participants
18 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
19 Participants
n=5 Participants
19 Participants
n=7 Participants
38 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
8 Participants
n=5 Participants
9 Participants
n=7 Participants
17 Participants
n=5 Participants
Race (NIH/OMB)
White
10 Participants
n=5 Participants
9 Participants
n=7 Participants
19 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
9 Participants
n=5 Participants
8 Participants
n=7 Participants
17 Participants
n=5 Participants
Region of Enrollment
United States
29 Participants
n=5 Participants
28 Participants
n=7 Participants
57 Participants
n=5 Participants
Patient Health Questionnaire (PHQ-9)
15.4 units on a scale
STANDARD_DEVIATION 4.9 • n=5 Participants
14.6 units on a scale
STANDARD_DEVIATION 5.2 • n=7 Participants
15.1 units on a scale
STANDARD_DEVIATION 5.0 • n=5 Participants

PRIMARY outcome

Timeframe: 3-months

The Patient Health Questionnaire (PHQ-9) is a scale commonly used to measure and categorize depression symptoms. It is already administered as part of routine primary care at our study site. The minimum score is 0, the maximum is 27. A higher score indicates a worse outcome (i.e. more severe depression symptoms).

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=21 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=21 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Patient Health Questionnaire (PHQ-9)
12.6 score on a scale
Standard Deviation 5.2
15.2 score on a scale
Standard Deviation 5.1

SECONDARY outcome

Timeframe: 3-months

The 10-item PROMIS Global Health assesses health-related quality of life and is summarized into "physical health" (physical functioning, pain, fatigue) and "mental health" (emotional problems, social functioning). Raw scores are summed (minimum score for either physical health or mental health=4, maximum score for either =20) and converted to a t-score by using a conversion table (minimum t-score for physical health=16.2, maximum =67.7; minimum t-score for mental health=21.2, maximum =67.6). A score of 50, with a standard deviation of 10, is the average for the United States general population. For both the physical and mental health, a higher score indicates a better outcome (i.e., better health). For physical health, a score of 35 or less is reflective of "poor" physical health, and 36-42 of "fair". Similarly, for mental health, a score of 29 or less is reflective of "poor" mental health, 29-40 of "fair".

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=21 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=21 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
PROMIS Global Health
Physical Health
38.3 t-score
Standard Deviation 7.1
38.7 t-score
Standard Deviation 8.4
PROMIS Global Health
Mental Health
36.9 t-score
Standard Deviation 6.1
38.2 t-score
Standard Deviation 6.5

SECONDARY outcome

Timeframe: 3-months

The 7-item Generalized Anxiety Disorder (GAD-7) is among the most commonly used and best validated anxiety measures in primary care settings. The minimum score is 0, the maximum is 21. Higher scores indicate a worse outcome (i.e., more severe anxiety). For reference: scores of 0-4=minimal anxiety, 5-9=mild anxiety, 10-14=moderate anxiety, and 15-21=severe anxiety.

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=21 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=21 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Generalized Anxiety Disorder (GAD-7)
9.6 score on a scale
Standard Deviation 5.8
10.6 score on a scale
Standard Deviation 5.2

SECONDARY outcome

Timeframe: 3-months

The 13-item Patient Activation Measure (PAM) will be used to assess an individual's knowledge, skill, and confidence for self-management. The minimum score is 0, the maximum is 100. Higher scores indicate a better outcome (i.e., higher patient activation).

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=21 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=21 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Patient Activation Measure (PAM)
37.5 score on a scale
Standard Deviation 4.2
38.6 score on a scale
Standard Deviation 5.4

SECONDARY outcome

Timeframe: 3-months

The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-reported measure that will be used to assesses PTSD symptoms and symptom change. The minimum score is 0, the maximum is 80. Higher score indicate a worse outcome (i.e., more severe PTSD symptoms).

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=21 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=21 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
PTSD Checklist for DSM-5 (PCL-5)
30.1 score on a scale
Standard Deviation 19.5
34.0 score on a scale
Standard Deviation 16.7

SECONDARY outcome

Timeframe: 3-months

The 9-item Behavioral Activation for Depression Scale (BADS-SF) will also be used to examine behavioral activation as an intermediary to depression symptomatology outcomes. The minimum score is 0, the maximum is 54. Higher scores indicate a better outcome (i.e., higher activation).

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=21 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
n=21 Participants
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Behavioral Activation for Depression Scale (BADS-SF)
21.4 score on a scale
Standard Deviation 9.1
22.6 score on a scale
Standard Deviation 7.8

OTHER_PRE_SPECIFIED outcome

Timeframe: 3-months

Population: Usual care participants were not given the opportunity to use the cCBT program.

Treatment engagement will be conceptualized as the number of cCBT sessions completed. The minimum number of sessions is 0 and the maximum is 11. A higher number indicates more cCBT sessions completed, but isn't indicative of a better or worse outcome.

Outcome measures

Outcome measures
Measure
cCBT Enhanced Collaborative Care
n=29 Participants
Participants in the intervention arm will receive computerized cognitive behavioral therapy (cCBT) supported by a depression care manager in addition to the usual care provided. cCBT Enhanced Collaborative Care: Computerized CBT (cCBT) will be delivered supported by a depression care manger who will facilitate access to cCBT, promote and monitor cCBT use, reinforce CBT concepts (during outside CBT session "homework"), and monitor mental health symptoms for each participant.
Usual Care
Participants in the usual care arm will receive the usual care provided as described below. Usual Care: Primary Care Provider supported usual care typically includes medication prescription and referrals to specialty mental health, including Primary Care - Mental Health Integration services.
Treatment Engagement
6.7 number of sessions
Standard Deviation 4.9

Adverse Events

cCBT Enhanced Collaborative Care

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

Usual Care

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

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Lucinda B. Leung, MD, PhD, MPH

VA Greater Los Angeles Healthcare System, UCLA David Geffen School of Medicine

Phone: 310-478-3711

Results disclosure agreements

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