- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00137306
Facilitating the Adoption of Evidence-Based Depression Management in Substance Use Treatment Programs
Translating Depression Guidelines Into Substance Abuse Treatment
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
Background:
Comorbid depression has been consistently linked to worse outcomes for patients in substance abuse treatment programs. Practice guidelines recommend pharmacotherapy for comorbid depression if symptoms persist after a 4-week "wash-out" period for detoxification (e.g., Veterans Health Administration; American Psychiatric Association). Medications may be considered earlier if a patient has current symptoms and a history of major depressive disorder (MDD) during periods of sobriety. Current efficacy data suggest that antidepressant medication can improve both depression and substance use outcomes among comorbid patients Guideline-concordant use of antidepressant medication for persons with comorbid substance use and depressive disorders, however, is not routine in many VA substance abuse treatment settings.
Objectives:
This study seeks to develop, implement, and test an organizational intervention in VA substance abuse treatment settings to establish guideline-concordant treatment of comorbid depression. The intervention will assist "intervention" programs in their own implementation of a guidelines-based treatment algorithm to improve the recognition of depression and initiation of pharmacotherapy.
Methods:
Substance abuse treatment programs in the South Central VISN were matched on program characteristics and current depression management practices (n = 4), and "intervention" sites were randomly chosen from each pair. Phase 1 (now completed) of the study analyzed the barriers and facilitators to translation of depression management in participating facilities, and used these data to inform the development of the translation intervention, its implementation tools, and the depression algorithm. The translation intervention adopted in this plan was based on the PRECEDE model of organizational behavior change and included provider education, use of local champions, feedback of screening data, and patient education/activation. The depression management algorithm and intervention was developed with input from programs staff and an Advisory Panel of depression management and translation experts. Phase 2 of the study implemented and tested the intervention. The evaluation in examining program- and provider-level outcomes. Program-level outcomes include feasibility, extent of adoption of the algorithm, and provider/organizational attitudes and beliefs about the intervention's design and effectiveness. Patient-level outcomes include depressive symptoms, substance use outcomes, medication adherence, quality of life, and services use.
Status:
Phase 1 of the study is complete. Phase 2 is near complete.
Studientyp
Einschreibung (Voraussichtlich)
Phase
- Phase 4
Kontakte und Standorte
Studienorte
-
-
Arkansas
-
No. Little Rock, Arkansas, Vereinigte Staaten, 72114-1706
- Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR
-
-
Louisiana
-
New Orleans, Louisiana, Vereinigte Staaten, 70112
- Southeast Louisiana Veterans Health Care System, New Orleans, LA
-
-
Mississippi
-
Biloxi, Mississippi, Vereinigte Staaten, 39531
- VA Gulf Coast Veterans Health Care System
-
Jackson, Mississippi, Vereinigte Staaten, 39216
- G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
- Oklahoma City, OK
-
-
Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
- Kind
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
Programs: VA's offering residential or intensive outpatient treatment for substance-related disorders in VISN 16 Patients: Veterans in residential or intensive outpatient treatment for substance-related disorders; positive screen for non-substance-induced depressive disorder
Exclusion Criteria:
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Sonstiges: Arm 1
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
---|
Program: extent, quality of adoption of protocolPatient: scores on-depression, substance use, and functioning scales
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
---|
Programs: Staff satisfaction with protocol/intervention Patients: medication adherence
|
Mitarbeiter und Ermittler
Ermittler
- Hauptermittler: Geoffrey M. Curran, PhD, Central Arkansas Veterans Healthcare System Eugene J. Towbin Healthcare Center, Little Rock, AR
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Curran GM, Mukherjee S, Allee E, Owen RR. A process for developing an implementation intervention: QUERI Series. Implement Sci. 2008 Mar 19;3:17. doi: 10.1186/1748-5908-3-17.
- Curran GM, Kirchner JE, Worley M, Rookey C, Booth BM. Depressive symptomatology and early attrition from intensive outpatient substance use treatment. J Behav Health Serv Res. 2002 May;29(2):138-43. doi: 10.1007/BF02287700.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- SUT 02-211
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
Klinische Studien zur Substanzbezogene Störungen
-
Hospices Civils de LyonAbgeschlossenNeuromyelitis-Optica-Spektrum-Erkrankungen | Neuromyelitis optica Spectrum Related DisordersFrankreich
-
Abbott Medical DevicesThoratec CorporationAbgeschlossenDriveline Heart-assisted Device Related InfectionVereinigte Staaten
-
Cure CMDRekrutierungEmery-Dreifuss-Muskeldystrophie | Angeborenes myasthenisches Syndrom | Gliedergürtel-Muskeldystrophie | Angeborene Muskeldystrophie mit ITGA7 (Integrin Alpha-7)-Mangel | Alpha-Dystroglykanopathie (angeborene Muskeldystrophie und abnormale Glykosylierung von Dystroglykan bei schwerer Epilepsie) und andere BedingungenVereinigte Staaten
Klinische Studien zur Facilitate evidence-based treatment for depression
-
Michigan State UniversityNational Institute of Nursing Research (NINR)AbgeschlossenBrustkrebsVereinigte Staaten