Partnership in Medication Management (PIMM) in Patients With Mood Disorders (PIMM)
17 novembre 2015 mis à jour par: St. Joseph's Healthcare Hamilton
Partnership in Medication Management (PIMM): The Effects of One-on-one Medication Training on Medication Adherence in Patients With Mood Disorders
Investigators are doing this study to examine if a new personalized education program for patients with mood disorders (depression and bipolar disorders) will help them take their medications as prescribed by doctors.
Investigators will teach patients about how, when and why it is important for them to take their medications as prescribed.
Also, investigators will ask patients why they do not take medications as prescribed.
Furthermore, investigators will examine whether our education program might save money if it prevents problems related to not taking medication.
Aperçu de l'étude
Statut
Inconnue
Les conditions
Intervention / Traitement
Description détaillée
The efficacy of anti-depressants or lithium reported in clinical trials differs from clinical experience. Various factors such as non-adherence to treatment and poor tolerability to medications have been related to treatment non-response or treatment failure in mood disorders (major depressive disorder and bipolar disorder). Premature discontinuation of treatment for mood disorders is common. The long treatments, the patients' beliefs about medications, the lack of knowledge about the medication/treatment purpose, benefits, dosage, and side effects and the relationship between patient and healthcare providers affect treatment continuation.
Investigators are proposing a sequential explanatory mixed methods study to investigate a novel program for medication training in persons with mood disorders. The ultimate purpose of the program is to improve medication adherence in these persons. The primary component of the present study will be quantitative, i.e., a randomized controlled trial with 12 months of follow-up to examine the effect of one-on-one medication training, including the use of a checklist system, on medication adherence in patients with mood disorders. The training program will include education to improve patients' knowledge regarding their medication's purpose, dosage, benefits, and side effects. The program will also include tools like a checklist or alarm clock to remind patients of when and how to take their medication. Furthermore, the program will contain an interactive listening period where healthcare professionals involved in medication dispensing will listen to patients' concerns, questions and thoughts regarding their medications. To the best of the investigators' knowledge, no research has comprehensively examined whether one-on-one medication training, as described above, may improve medication adherence in patients with mood disorders.
Type d'étude
Interventionnel
Inscription (Anticipé)
166
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
-
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Ontario
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Hamilton, Ontario, Canada, L8N 4K7
- Recrutement
- Mood Disorders Program, St. Joseph's Healthcare Hamilton
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Contact:
- Carolina Oremus, MD,PhD(c)
- Numéro de téléphone: 36326 +1(905) 522-1155
- E-mail: coremus@stjoes.ca
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Contact:
- Margaret C McKinnon, PhD,C.Psych.
- Numéro de téléphone: 36645 +1(905) 522-1155
- E-mail: mmckinno@stjoes.ca
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- admitted to the inpatient clinic of the Mood Disorders Program, St. Joseph's Healthcare Hamilton
- with a primary diagnosis of bipolar disorder I or II, or major depressive disorder
- able to speak, read, and understand English.
Exclusion Criteria:
- cut off score on Montreal Cognitive Assessment (MOCA; clinical judgement)
- significant suicidal or homicidal risk
- a medical condition/treatment known to affect the brain
- acquired brain injury.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Recherche sur les services de santé
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: PIMM/SAM
Partnership in Medication Management (PIMM): The nurse and the attending physician will meet with the patient and ask how s/he administers medication at home (i.e., blister pack).
Initial education session: the nurse will teach the patient about his/her medications, dosage, purpose, when and how to take them.
Nurse and patient will establish reminders to take his/her medication.
Following the education session, patients will be required to notify the nurse when it is time to take their medications, where their medications are, dosage, purpose and side effects.
Self-Administered Medication (SAM): Patients will transition to SAM once the clinical team feels that no further medication changes are required.
SAM is also the model that the participants will follow after discharge.
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The PIMM program will include education to improve patients' knowledge regarding their medication's purpose, dosage, benefits, and side effects.
The program will also include tools like a checklist or alarm clock to remind patients of when and how to take their medication.
Furthermore, the program will contain an interactive listening period where healthcare professionals involved in medication dispensing will listen to patients' concerns, questions and thoughts regarding their medications.
Autres noms:
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Aucune intervention: Standard Prescribing Practice(SPP)
Standard prescribing practice (SPP): medication administration will proceed as standard practice.
Patients will not receive a personalized medication training.
The nurse will administer the patient's medications.
However, patients are encouraged to ask any questions regarding his/her medications.Patients will not be provided with any tool to help them to remember when to take their medications.
The nurse will record the patient's knowledge regarding his/her medications.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Medication adherence measured by the Medication Adherence Rating Scale (MARS).
Délai: Change from baseline in the Medication Adherence Rating Scale at 2 days before discharge and 1 week, 1 month, 3 months, 6 months and 12 months post-discharge
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Medication adherence measured by the Medication Adherence Rating Scale (MARS).
We will measure medication adherence at baseline and each follow up
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Change from baseline in the Medication Adherence Rating Scale at 2 days before discharge and 1 week, 1 month, 3 months, 6 months and 12 months post-discharge
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Time to re-hospitalization
Délai: First time re-hospitalization any point during the 12-month follow-up period
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Investigators will compare the time to re-hospitalization between each study group.
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First time re-hospitalization any point during the 12-month follow-up period
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Costs of re-hospitalization
Délai: First time re-hospitalization any point during the 12-month follow-up period
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Investigators will adopt a healthcare system perspective and compare the costs of first re-hospitalization between each study group.
When a participant is re-hospitalized for the first time at any point during the 12-month follow-up period, investigators will conduct a chart review of the entire re-hospitalization to identify all of the direct and indirect medical resources consumed during this re-hospitalization.
The chart review will cover the entire length of the re-hospitalization, even if this length exceeds the 12-month follow-up period for the participant in question.
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First time re-hospitalization any point during the 12-month follow-up period
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Carolina Oremus, MD, PhD(c), McMaster University
- Chercheur principal: Sharon Simmons, RN,BScN,CPMHNc, St. Joseph's Healthcare Hamilton
- Chercheur principal: Margaret C McKinnon, PhD,C.Psych., McMaster University
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- The World Health Organization.The global burden of disease: 2004 update, Table A2: Burden of disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004. Geneva, Switzerland, 2008 (accessed on: March 6, 2014).
- Health Canada. A Report on Mental Illnesses in Canada. Ottawa: Health Canada, 2002.
- World Health Organization. Adherence to Long- Term Therapies: Evidence for Action. Geneva, Switzerland: World Health Organization, 2003.
- Rosa AR, Marco M, Fachel JM, Kapczinski F, Stein AT, Barros HM. Correlation between drug treatment adherence and lithium treatment attitudes and knowledge by bipolar patients. Prog Neuropsychopharmacol Biol Psychiatry. 2007 Jan 30;31(1):217-24. doi: 10.1016/j.pnpbp.2006.08.007. Epub 2006 Sep 18.
- Nemeroff CB, Heim CM, Thase ME, Klein DN, Rush AJ, Schatzberg AF, Ninan PT, McCullough JP Jr, Weiss PM, Dunner DL, Rothbaum BO, Kornstein S, Keitner G, Keller MB. Differential responses to psychotherapy versus pharmacotherapy in patients with chronic forms of major depression and childhood trauma. Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):14293-6. doi: 10.1073/pnas.2336126100. Epub 2003 Nov 13. Erratum In: Proc Natl Acad Sci U S A. 2005 Nov 8;102(45):16530.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 janvier 2015
Achèvement primaire (Anticipé)
1 novembre 2016
Achèvement de l'étude (Anticipé)
1 mai 2017
Dates d'inscription aux études
Première soumission
28 octobre 2014
Première soumission répondant aux critères de contrôle qualité
6 novembre 2014
Première publication (Estimation)
7 novembre 2014
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
18 novembre 2015
Dernière mise à jour soumise répondant aux critères de contrôle qualité
17 novembre 2015
Dernière vérification
1 novembre 2015
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- PIMM MDP
- PIMM Mood Disorders Program (Autre subvention/numéro de financement: Mood Disorders Program, St. Joseph/s Healthcare Hamilton)
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