Medication Treatment for Depression in Nursing Home Residents
Drug Treatment of Depression in the Nursing Home Aged
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
There are approximately 1.6 million nursing home residents in the United States. More than one third of these residents are taking antidepressant medications (ADs). Although ADs are effective, evidence suggests that they can lead to significant adverse events, including an increased risk of falls and bone fractures. Many depressed nursing home residents suffer from an initial episode of late-life depression and do not meet guideline-based recommendations for maintenance treatment. This study will examine the benefits and risks of long-term AD treatment in depressed nursing home residents whose single episode of depression has been in continuous remission for at least six months.
Participants will be randomly assigned to either continue or discontinue AD treatment. Participants will be monitored over a period of one year for recurrence of depression and related symptoms, as well as for the occurrence of falls, fractures, and other adverse events. Medical chart review, self-reported mood symptoms, and depression scales will be used to assess participants.
Undersøgelsestype
Tilmelding (Faktiske)
Kontakter og lokationer
Studiesteder
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Forenede Stater, 19104
- University of Pennsylvania
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Current use of antidepressant medication
- Have been in remission from first episode of depression for 6 months or longer
- Currently residing in a long term care or assisted living facility
Exclusion Criteria:
- Bedridden
- Severe cognitive impairment
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
|---|---|
|
Randomized to drug continuation
Participants assigned to continue current antidepressant medication
|
Participants assigned to continue current medication will be monitored over a period of one year for recurrence of depression and related symptoms.
|
|
Randomized to drug discontinuation
Participants assigned to discontinue current antidepressant medication (no antidepressant medication)
|
Participants assigned to discontinue current medication (no antidepressant medication) will be monitored over a period of one year for recurrence of depression and related symptoms.
|
|
Participant preference to continue drug
Chose to continue antidepressant medication
|
Participants assigned to continue current medication will be monitored over a period of one year for recurrence of depression and related symptoms.
|
|
Participant preference to discontinue drug
Chose to discontinue antidepressant medication (no antidepressant medication)
|
Participants assigned to discontinue current medication (no antidepressant medication) will be monitored over a period of one year for recurrence of depression and related symptoms.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Geriatric Depression Scale (GDS) Score
Tidsramme: Measured at Month 12
|
The GDS scale measures presence and severity of depressive symptoms in older adults.
Scores range from zero (no depression symptoms) to thirty (severe depression symptoms).
|
Measured at Month 12
|
|
Number of Falls Experienced by Participants Over Twelve Months of Surveillance
Tidsramme: Measured from Baseline through Month Twelve
|
Measured from Baseline through Month Twelve
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Cognitive Function (MMSE)
Tidsramme: Measured at Month 12
|
The Mini Mental State Examination (MMSE) measures cognitive function in multiple domains, including memory, orientation, language, and executive function.
Scores range from zero (severe cognitive impairment) to thirty (intact cognitive function).
|
Measured at Month 12
|
Samarbejdspartnere og efterforskere
Sponsor
Samarbejdspartnere
Efterforskere
- Ledende efterforsker: Joel E. Streim, MD, University of Pennsylvania
Publikationer og nyttige links
Generelle publikationer
- Streim JE, DiFilippo S, TenHave T, Mavandadi S, Weintraub D, Oslin D. Antidepressant discontinuation associated with cognitive decline in older adult residents of long-term care facilities. Am J Geriatr Psychiatry 20(3) (supplement 1): S147-148, 2012.
Datoer for undersøgelser
Studer store datoer
Studiestart
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- R37MH051247 (U.S. NIH-bevilling/kontrakt)
- DSIR AT-GP
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