A Pilot With Interactive Computer-assisted Screening for Mental Health in Primary Care (iCAS)

Interactive Computer-assisted Screening for Mental Health in Primary Care

The current protocol pertains to the evaluation of the interactive computer-assisted screening (iCAS) tool through a pilot randomized control trial. The purpose of this evaluation is to determine the efficacy of the iCAS tool in improving clinician's detection of common mental health conditions (i.e. major depression/generalized anxiety/post-traumatic stress disorder/alcohol dependence), and patients' discussion on mental health.

Study Overview

• Status: Completed
• Conditions: Mental Health Disorders
• Intervention / Treatment: Behavioral: Interactive computer-assisted screening (iCAS)

Detailed Description

The iCAS tool is a health-risk assessment survey that is completed by adult patients using touch-screen iPad device in their waiting time before seeing their clinician (family physician or nurse practitioner). The computer program generates tailored risk-report for the clinician and a simple recommendation sheet for the patient, with community resources and health information, at the point of care. The iCAS tool currently includes validated screening scales for depression, generalized anxiety, posttraumatic stress disorder and alcohol abuse. There are some questions on the social determinants of mental health as well. The current versions of the tool are in English and Spanish; a Chinese language version will also be developed.

• Study Type: Interventional
• Enrollment (Actual): 154
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M3J 1P3
      • York University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• At least 18 years of age
• Speak/read Spanish
• Speak/read English
• Visiting the consenting clinician

Exclusion Criteria:

• Patient accompanied by a family member for interpretation
• New patients coming for first visit
• Patients feeling unwell (self-report)
• Inability of the research staff to offer study details in privacy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Interactive computer-assisted screening; Eligible patients completed the interactive computer-assisted screening (iCAS) tool in English or Spanish before seeing the consenting clinician. Participating patients then received the iCAS generated tailored recommendation sheet. Participating clinicians received the iCAS generated risk report.	Behavioral: Interactive computer-assisted screening (iCAS)
No Intervention: Usual Care; Eligible patients randomized to the control group completed their standard visit to the participating clinician. There was no pre-visit health risk screening. There were no tailored reports for the patients or clinicians.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinician Detection (probable, sub-clinical, confirmed) of major depression or generalized anxiety or post-traumatic stress disorder or alcohol dependence	Chart review for the index visit	Day 1
Patient discussion on mental health	Exit Survey of patients after the index visit	Day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient intention to see a mental health counselor	Exit Survey of patients after the index visit	Day 1
Patient satisfaction with health services	Exit Survey of patients after the index visit	Day 1
Patient enablement to cope with these conditions	Exit Survey of patients after the index visit	Day 1
Patient adherence to follow-up advice and referrals to mental health support	Chart review	3 month

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Symptom reduction	Measurement of this outcome depends on availability of funds for follow-up phone interviews	6 month

Collaborators and Investigators

• Sponsor: York University
• Collaborators: Canadian Institutes of Health Research (CIHR); North York General Hospital
• Investigators: Principal Investigator: Farah Ahmad, PhD, York University

Publications and helpful links

General Publications

• Ahmad F, Lou W, Shakya Y, Ginsburg L, Ng PT, Rashid M, Dinca-Panaitescu S, Ledwos C, McKenzie K. Preconsult interactive computer-assisted client assessment survey for common mental disorders in a community health centre: a randomized controlled trial. CMAJ Open. 2017 Mar 1;5(1):E190-E197. doi: 10.9778/cmajo.20160118. eCollection 2017 Jan-Mar.
• Ferrari M, Ahmad F, Shakya Y, Ledwos C, McKenzie K. Computer-assisted client assessment survey for mental health: patient and health provider perspectives. BMC Health Serv Res. 2016 Sep 23;16(1):516. doi: 10.1186/s12913-016-1756-0.

Study record dates

Study Major Dates

• Study Start: November 1, 2013
• Primary Completion (Actual): May 1, 2014
• Study Completion (Actual): May 1, 2014

Study Registration Dates

• First Submitted: December 12, 2013
• First Submitted That Met QC Criteria: December 24, 2013
• First Posted (Estimate): December 30, 2013

Study Record Updates

• Last Update Posted (Estimate): June 3, 2016
• Last Update Submitted That Met QC Criteria: June 1, 2016
• Last Verified: June 1, 2016

More Information

Terms related to this study

• Keywords: Primary Care; Randomized; Open Label; Interactive Health-risk assessment; Efficacy Study
• Additional Relevant MeSH Terms: Mental Disorders
• Other Study ID Numbers: e2013 - 291

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided