Prevention of Suicide in the Elderly

October 25, 2013 updated by: Weill Medical College of Cornell University

The purpose of this study is to design a program to prevent suicide in elderly patients by educating patients, their families, and physicians on depression and suicidal thoughts.

A program to prevent suicide in elderly patients needs to be developed. Since elderly patients frequently have doctor's visits, it may be best to have a suicide prevention program based in the patient's doctor's office.

When an older person visits a primary care physician, he/she will check for signs of depression, including thoughts of suicide. The doctor will speak to the patient about depression and how to recognize it. If the individual is diagnosed with depression, the doctor will offer treatment. During this study, the information the doctor collects will be used to evaluate the effectiveness of the program. The study will last for 2 years.

Eligibility for this study is age of at least 60 years and diagnosis of depression. (Depression required for 920 of the 1200 patients; 280 patients should have no symptoms of depression.)

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

To investigate the effectiveness of an intervention aimed at improving the recognition of suicidal ideation and depression in elderly patients and facilitating the implementation of a treatment algorithm based on the AHCPR (Agency for Health Care Policy and Research) guidelines. To implement procedures aimed at educating patients, families, and physicians on depression and suicidal ideation.

There is a need to test models of depression recognition and treatment to prevent and reduce suicidal behavior in older patients in primary care settings. Elderly suicide most frequently occurs in the context of mild to moderate depression. In primary care patients, suicidal ideation is a risk factor for suicide and has been identified almost exclusively in patients with depressive symptoms and signs. Since most suicide victims are seen by their primary care physicians within a few weeks prior to their death, intervening at the doctor's office may be life-saving.

The intervention is offered in 6 primary care practices from 3 geographic areas (metropolitan and suburban New York, Philadelphia, and Pittsburgh) and its impact is contrasted to that of 6 comparable practices offering usual care. Patients are selected through an age-stratified, two-stage sampling design and followed for 2 years. The group consists of 1,200 subjects and is comprised of patients with depressive symptoms and signs and a random sample of patients without significant depressive symptomatology. Depression Specialists (DS) collaborate with physicians and help them increase recognition, offer timely and appropriately-targeted treatment recommendations, and encourage patients to adhere to treatment. Beyond direct systematic clinical assessment of patients, information is obtained on health services utilization from practice-based medical records and on cause of death from death certificates. Data are also collected to document the impact of intervention on patient care, and on physician knowledge, attitudes, and satisfaction and test hypotheses derived from preliminary studies of the three Intervention Research Centers (IRCs), Cornell, University of Pennsylvania, and University of Pittsburgh, where the study will be conducted.

Study Type

Interventional

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • White Plains, New York, United States, 10605
        • New York Presbyterian Hospital/Westchester Division

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

60 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

-

Patients must have:

Depressive symptoms and signs. (Required for 920 of the 1200 patients; 280 patients should have no significant depressive symptomatology.)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Weill Medical College of Cornell University

Collaborators

National Institute of Mental Health (NIMH)

Investigators

  • Principal Investigator: George Alexopoulos, MD

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 1998

Study Completion

August 1, 2003

Study Registration Dates

First Submitted

November 2, 1999

First Submitted That Met QC Criteria

November 2, 1999

First Posted (Estimate)

November 3, 1999

Study Record Updates

Last Update Posted (Estimate)

October 29, 2013

Last Update Submitted That Met QC Criteria

October 25, 2013

Last Verified

October 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • R01MH059366 (U.S. NIH Grant/Contract)
  • DSIR AT-P

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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