- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04836585
eMBC for Perinatal Depression and Anxiety (eMBC)
Technology-Enabled (Electronic) Measurement Based Care(MBC) for Perinatal Depression and Anxiety: A Pilot Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
A parallel group randomized controlled trial (RCT) will be conducted. Eligible and consenting patients with depression and/or anxiety will be randomized in a 1:1 ratio to either the eMBC condition or a control condition. The study will be stratified by diagnosis (major depressive disorder vs generalized anxiety disorder).
80 patient participants will be recruited from the Reproductive Life Stages (RLS) Program at Women's College Hospital. The active treatment phase of the study is 12 weeks.
Outcomes will be measured online and by phone at 4-, 8-, and 12- weeks post-randomization. Following the completion of the study, some participants will be asked to participate in follow-up interviews. RLS psychiatrists whose patients participated in the study will participate in a focus group.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Simone Vigod, MD, MSc
- Phone Number: 4080 416-323-6400
- Email: simone.vigod@wchospital.ca
Study Locations
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Ontario
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Toronto, Ontario, Canada, M5S 1B2
- Women's College Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18
Currently pregnant or mother* of a live infant 0-12 months of age and living at the same residence
*Through natural birth, adoption, surrogacy, including cis women, non-binary and transgender people in all their diversity
- EPDS >12 at enrollment
Exclusion Criteria:
- Active suicidal ideation, substance abuse or dependence
- Current or past mania or psychosis or current major depressive episode with psychosis
4. Incapable of consenting to participation 5. Unable to read or unable to speak English
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Care As Usual
Participants in the control condition are followed by their RLS psychiatrists during the study as per usual care.
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Experimental: eMBC Intervention
Participants in the intervention arm are followed by their RLS psychiatrists during the study at clinically appropriate intervals with the addition of eMBC.
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The treating psychiatrist sets a flag in the patient's electronic chart that prompts them to complete self-report scales prior to each appointment:
Patient participants and providers can view the questionnaire results over time in the electronic chart item by item, and/or see them in graphical format. During the clinical encounter, the provider and patient participant review the results of the scales, as part of a collaborative re-evaluation of the treatment plan. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of the trial protocol: Recruitment
Time Frame: 12 weeks post randomization
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Measures of recruitment include rate of recruitment and reason for non-participation.
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12 weeks post randomization
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Feasibility of the trial protocol: Participant Acceptability
Time Frame: 12 weeks post randomization
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Surveys and interviews will be used to capture data relating to perceived usefulness and acceptability of technology and its perceived benefit.
These will be combined to capture an overall acceptability measure.
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12 weeks post randomization
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Feasibility of the trial protocol: Provider Acceptability
Time Frame: 12 weeks post randomization
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Surveys and focus groups will be used to capture data relating to usability and tolerability of eMBC in clinical practice.
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12 weeks post randomization
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Feasibility of the trial protocol: Adherence
Time Frame: 12 weeks post randomization
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Chart review will be used to measure the number of visits, the proportion of visits with completed scales and which scales were completed, proportion of visits where review of symptom scales was documented in the patient record, the proportion of visits where providers recorded that they used the data from symptom scales to inform the treatment, and proportion of visits where medication was started, changed, dose adjusted or stopped.
These will be combined to provide an overall measure of how closely the intervention protocol was followed.
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12 weeks post randomization
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical outcomes - clinician-assessed depression symptoms
Time Frame: 4, 8, and 12 weeks post randomization
|
The Montgomery-Asberg Depressive Rating Scale (MADRS) is a standard clinician-administered measure of depressive symptoms with good reliability and validity in clinical populations.
The MADRS has good responsiveness to the effect of anti-depressant treatments.
The 17-items are rated on a 7-point (0-6) (score range 0-60), with lower scores indicating fewer symptoms of depression and higher scores indicating a higher degree of symptoms.
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4, 8, and 12 weeks post randomization
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Clinical outcomes - self-report depression symptoms
Time Frame: each clinical appointment up to 12 weeks post randomization
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Depressive symptoms will be measured using the Edinburgh Postnatal Depressive Scale (EPDS), a self-report scale that has been validated for use in pregnancy and postpartum.
EPDS scores range from 0 to 30.
EPDS scores >12 are predictive of a diagnosis of depression, with higher scores indicating more severe symptoms.
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each clinical appointment up to 12 weeks post randomization
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Clinical outcomes - anxiety symptoms
Time Frame: 4, 8, and 12 weeks post randomization
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The Hamilton Anxiety Rating Scale (HAM-A) is a clinician-rated measure that assesses the severity of symptoms of anxiety.
The HAM-A has good reliability and validity in populations with depression and anxiety.
The 14-items are rated on a 5-point scale (0-4) with scores ranging from 0-56.
Scores <17 indicate mild severity, 18-24 mild to moderate severity and 25-30 moderate to severe symptoms.
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4, 8, and 12 weeks post randomization
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Clinical outcomes - functional capacity
Time Frame: each clinical appointment up to 12 weeks post randomization
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The PROMIS Neuro-QOL - Ability to Participate in Social Roles and Activities - Short Form is a brief self-report tool used to measure functional capacity.
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each clinical appointment up to 12 weeks post randomization
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Clinical outcomes - social functioning
Time Frame: each clinical appointment up to 12 weeks post randomization
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PROMIS ASCQ-Me Social Functioning - Short Form is a brief self-report tool used to measure functional capacity.
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each clinical appointment up to 12 weeks post randomization
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Clinical outcomes - antidepressant side effects
Time Frame: each clinical appointment up to 12 weeks post randomization
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The Frequency, Intensity, and Burden Side Effects Rating (FIBSER) Scale is a brief 3-item scale used to measure three domains of anti-depressant side effects including frequency, intensity, and burden of antidepressant medication.
The last question relating to burden is scored 0-6 with low scores indicating no medication adjustment is needed, and high scores indicating that the dose needs to be decreased or the medication changed.
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each clinical appointment up to 12 weeks post randomization
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Co-variates: Participants
Time Frame: Baseline
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Sociodemographic, obstetrical, and psychiatric history data will be collected on the Baseline Questionnaire.
A diagnostic phone interview using the Mini International Neuropsychiatric Interview (MINI) will be conducted for major depressive disorder, obsessive-compulsive disorder, panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder and post-traumatic stress disorder.
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Baseline
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Co-variates: Providers
Time Frame: Baseline
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Provider co-variates including age, number of years in practice, familiarity with technology, use of technology in their practice, and use of MBC prior to this study.
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Baseline
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Renu Gupta, MD, Women's College Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020-0090-B
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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