Telephone-Based Support Programs for People With Epilepsy
NYU Managing Epilepsy Well (MEW) Study: A Randomized Controlled Trial of Telephone-Based Support for People With Epilepsy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The objectives of the trial are:
- To test effects of UPLIFT versus BOOST on changes in depressive symptoms (primary outcome) in PWE over 12 months.
- To test effects of UPLIFT versus BOOST on changes in quality of life and seizures (secondary outcomes) in PWE over 12 months.
- To test whether intervention effects are mediated by increases in mindfulness and decreases in rumination.
- To test whether intervention effects are moderated by participant characteristics and facilitator characteristics.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Tanya Spruill, PhD
- Phone Number: 646-501-3429
- Email: Tanya.Spruill@nyulangone.org
Study Contact Backup
- Name: Alexis Bartelloni, MSPH
- Email: Alexis.Bartelloni@nyulangone.org
Study Locations
-
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New York
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New York, New York, United States, 10016
- Recruiting
- NYU Langone Health
-
Contact:
- Tanya Spruill, PhD
- Phone Number: 646-501-3429
- Email: Tanya.Spruill@nyulangone.org
-
Principal Investigator:
- Tanya Spruill, PhD
-
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- adult (≥18 years of age);
- diagnosed with epilepsy for at least one year;
- fluent in English or Spanish;
- elevated depressive symptoms (PHQ-9 score ≥10);
- willing to participate in audiotaped group telephone sessions
Exclusion Criteria:
- severe depressive symptoms (PHQ-9 ≥20);
- active suicidal ideation (PHQ-9 item #9 ≥1 or otherwise reported during screening);
- active psychotic disorder (psychiatric diagnosis or antipsychotic medications in the EHR);
- significant cognitive impairment (indicated in EHR or evident during screening)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm 1: UPLIFT (Using Practice and Learning to Increase Favorable Thoughts)
UPLIFT is a telephone-based depression self-management program for people with epilepsy.
|
UPLIFT is an 8-week program that combines cognitive behavioral therapy (CBT) and mindfulness techniques and is delivered to small groups of participants by phone.
Each weekly session is 1 hour long and is comprised of a check-in period, teaching on the week's topic, group discussion, a skill-building exercise, and a home practice assignment.
CBT-related skills include thought monitoring, identifying cognitive distortions, problem identification, goal setting, and identifying supports.
Relaxation exercises are also used for coping and to facilitate awareness of the body.
Mindfulness activities include attention to breath, sights and sounds and other meditations.
Audio guides are provided for home practice of mindfulness exercises.
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|
Active Comparator: Arm 2: BOOST (Bringing Out Our Strength Together)
BOOST is a telephone-based support program for people with epilepsy.
|
BOOST is a telephone-based support program delivered in 8 weekly group sessions.
Each weekly session is 1 hour long and is comprised of a check-in period, introduction of the week's topic, and group discussion.
Weekly BOOST session topics include: (1) personal experience of epilepsy; (2) personal experience of mood problems (depression, anxiety, stress); (3) seizure triggers; (4) concerns related to epilepsy treatment (e.g., medication adherence, side effects); (5) changes in seizures over time; (6) the impact of behavior (e.g., sleep, substance use) on seizures; (7) social relationships and epilepsy; and (8) review of the BOOST experience.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Presence of clinically significant depressive symptoms
Time Frame: Baseline Visit
|
The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5.
The PHQ-9 assesses depressive symptoms in the past two weeks.
Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms.
A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.
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Baseline Visit
|
|
Presence of clinically significant depressive symptoms
Time Frame: 3 month visit
|
The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5.
The PHQ-9 assesses depressive symptoms in the past two weeks.
Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms.
A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.
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3 month visit
|
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Presence of clinically significant depressive symptoms
Time Frame: 6 month visit
|
The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5.
The PHQ-9 assesses depressive symptoms in the past two weeks.
Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms.
A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.
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6 month visit
|
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Presence of clinically significant depressive symptoms
Time Frame: 12 month visit
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The primary outcome is a dichotomous measure of depressive symptoms based on a Patient Health Questionnaire (PHQ-9) score of <5 versus ≥5.
The PHQ-9 assesses depressive symptoms in the past two weeks.
Total scores range from 0-27 with recommended cutoffs for mild (5-9), moderate (10-14), moderately severe (15-19) and severe (≥20) depressive symptoms.
A PHQ-9 score of <5 indicates absence of clinically significant depressive symptoms.
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12 month visit
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in depressive symptom severity
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
Continuous PHQ-9 scores will be used to evaluate the magnitude of change in depressive symptoms.
The PHQ-9 consists of nine questions that ask respondents how often they've "been bothered by any of the following problems" in the past two weeks.
The questions address sleep, energy, appetite, and other possible symptoms of depression.
Scores are calculated based on how frequently a person experiences these feelings.
Score of 1-4 is considered minimal depression; score of 5-9 is considered mild depression; score of 10-14 is considered moderate depression; score of 15-19 is considered moderately severe depression; score of 20-27 is considered severe depression.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
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Change in seizure frequency
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
This will be assessed by self-reported 30-day seizure counts.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
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Change in seizure severity
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
This will be assessed by a 12-item version of the Liverpool Seizure Severity Scale.
The possible scoring ranges are between 7 and 32 for the percept scale and between 10 and 48 for the ictal/postictal scale.
The higher the score the more severe the seizures.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
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Change in disease-specific quality of life
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Quality of Life in Epilepsy-10 (QOLIE-10) questionnaire, a 10-item measure of epilepsy-specific aspects of qualify of life.
The QOLIE-10-P is a brief survey of health-related quality of life for adults with epilepsy.
There are 10 questions about health and daily activities, one question about how much distress you feel about problems and worries related to epilepsy, and a review of what bothers you most.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Change in general health-related quality of life
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS-10) questionnaire, a 10-item measure of global health (physical, mental and social functioning) developed by NIH as an indicator for Healthy People 2020.
The PROMIS Global-10 is a 10-item patient-reported questionnaire in which the response options are presented as 5-point (as well as a single 11-point) rating scales.
The results of the questions are used to calculate two summary scores: a Global Physical Health Score and a Global Mental Health score.
These scores are then standardized to the general population, using the "T-Score".
The average "T-Score" for the United States population is 50 points, with a standard deviation of 10 points.
Higher scores indicate a healthier patient.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in perceived social support
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
This will be assessed by the Interpersonal Support Evaluation List, a 12-item measure of the perceived availability of social support resources (appraisal, belonging, tangible support).
The ISEL-12 can be scored by summing the items to create an overall social support score; three subscale scores representing appraisal, belonging, and tangible social support have also been proposed.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Change in mindfulness
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Five Facet Mindfulness Questionnaire Short Form, a 15-item measure that assesses five dimensions of trait mindfulness: observing, describing, acting with awareness, non-judging of inner experience and non-reactivity to inner experience.
The following is the scoring information: Observing items: 1, 6, 11; Describe items: 2, 7R, 12 ; Acting with awareness items: 3R, 8R, 13R ; Non-judging items: 4R, 9R, 14R; Non-reactivity items: 5, 10, 15.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Change in rumination
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Ruminative Responses Scale, a 22-item measure that assesses how often participants engage in ruminative behaviors and cognitions in response to feeling sad or depressed.Each item are rated on a 4-point Likert scale ranging from 1 (never) to 4 (always).
The total score ranges from 22 to 88, with higher scores indicating higher degrees of ruminative symptoms.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Change in perceived stress
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Perceived Stress Scale, a 10-item measure of the degree which situations in one's life are appraised as overwhelming, uncontrollable and unpredictable over the last month.
The Perceived Stress Scale (PSS) is a classic stress assessment instrument.
Scores ranging from 0-13 would be considered low stress.
Scores ranging from 14-26 would be considered moderate stress.
Scores ranging from 27-40 would be considered high perceived stress.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
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Change in anxiety
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
This will be assessed by the Generalized Anxiety Disorder-7 Scale, a 7-item measure of anxiety symptoms in the past two weeks that is used to screen for clinically significant anxiety.
This is calculated by assigning scores of 0, 1, 2, and 3 to the response categories, respectively, of "not at all," "several days," "more than half the days," and "nearly every day."
GAD-7 total score for the seven items ranges from 0 to 21.
The higher the score, the greater the anxiety
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Change in epilepsy self management
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Epilepsy Self-Management Scale, a 38-item measure of the frequency of use of epilepsy self-management behaviors.
The ESMS scores range from 38 to 190, with higher scores reflecting an increased utilization of epilepsy self-management techniques.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Change in self-compassion
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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This will be assessed by the Self-Compassion Scale, a 12-item measure of thoughts, emotions and behaviors associated with self-compassion.
Average overall self-compassion scores tend to be around 3.0 on the 1-5 scale, a score of 1-2.5 indicates low self-compassion, 2.5-3.5 indicates moderate self-compassion and 3.5-5.0
means high self compassion.
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Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
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Change in healthcare utilization
Time Frame: Baseline Visit, 3 month visit, 6 month visit, 12 month visit
|
Self-reported outpatient (neurology/epilepsy and primary care/other specialist) and inpatient encounters will be obtained at each study visit.
|
Baseline Visit, 3 month visit, 6 month visit, 12 month visit
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Daniel Friedman, MD, NYU Langone Health
- Principal Investigator: Tanya Spruill, PhD, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 21-00446
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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