Implementing Telemedicine-Based Collaborative Care for MDD in Contract CBOCs - Full Text View

Sponsor:	Department of Veterans Affairs
Information provided by (Responsible Party):	Department of Veterans Affairs
ClinicalTrials.gov Identifier:	NCT00317018

Purpose

Small contract VA Community Based Outpatient Clinics present unique challenges to implementation of collaborative care because of their distinct organizational characteristics and lack of on-site psychiatrists. A recent effectiveness study, successfully used telemedicine technologies to adapt the collaborative care model for small rural VA Community Based Outpatient Clinics. The purpose of the proposed study is to implement this telemedicine-based collaborative care model in small Contract VA Community Based Outpatient Clinics and determine its sustainability and cost-effectiveness.

Condition	Intervention
Depression	Behavioral: Evidence-Based Quality Improvement

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Implementing Telemedicine-Based Collaborative Care for MDD in Contract CBOCs

Resource links provided by NLM:

MedlinePlus related topics: Adoption Depression

U.S. FDA Resources

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:

Reach, Effectiveness, Adoption, Implementation, and Maintenance, percent screening positive for depression, specialty mental health visits, antidepressant medication possession ratio, VA depression performance measure [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

cost-effectiveness [ Time Frame: 12 months ] [ Designated as safety issue: No ]

Enrollment:	0
Study Start Date:	May 2008
Study Completion Date:	September 2009
Primary Completion Date:	June 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
1 Implementation Group	Behavioral: Evidence-Based Quality Improvement The implementation intervention is known as Evidence-Based Quality Improvement (EBQI). EBQI is an adaptation of the Plan-Do-Study-Act cycles of Continuous Quality Improvement that emphasizes empirical evidence and the involvement of clinical and implementation experts (i.e., researchers). In the EBQI implementation intervention, both researchers (clinical and implementation experts) and local staff participate fully in the quality improvement process, with the researchers facilitating rather than dictating implementation efforts. Using EBQI methods, researchers and local staff adapt evidence-based practices for local resources, needs and preferences while maintaining fidelity to the evidence-base. PDSA cycles are used to continuously revise the adapted evidence-based practice based on feedback during pilot tests.
No Intervention: 2 Control Group

Arms

Assigned Interventions

1

Implementation Group

Behavioral: Evidence-Based Quality Improvement

The implementation intervention is known as Evidence-Based Quality Improvement (EBQI). EBQI is an adaptation of the Plan-Do-Study-Act cycles of Continuous Quality Improvement that emphasizes empirical evidence and the involvement of clinical and implementation experts (i.e., researchers). In the EBQI implementation intervention, both researchers (clinical and implementation experts) and local staff participate fully in the quality improvement process, with the researchers facilitating rather than dictating implementation efforts. Using EBQI methods, researchers and local staff adapt evidence-based practices for local resources, needs and preferences while maintaining fidelity to the evidence-base. PDSA cycles are used to continuously revise the adapted evidence-based practice based on feedback during pilot tests.

No Intervention: 2

Control Group

Show Detailed Description

Eligibility

Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

veteran
depression
patient at Little Rock VAMC, Loma Linda VAMC, or Greater Los Angeles VAMC

Exclusion Criteria:

veteran
depression
patient at Little Rock VAMC, Loma Linda VAMC, or Greater Los Angeles VAMC

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00317018

Locations

United States, Arkansas
Central Arkansas VHS Eugene J. Towbin Healthcare Ctr, Little Rock
No. Little Rock, Arkansas, United States, 72114-1706
United States, California
VA Medical Center, Loma Linda
Loma Linda, California, United States, 92357
VA Greater Los Angeles Healthcare System, West LA
West Los Angeles, California, United States, 90073

Sponsors and Collaborators

Department of Veterans Affairs

Investigators

Principal Investigator:

John C. Fortney, PhD

Central Arkansas VHS Eugene J. Towbin Healthcare Ctr, Little Rock

More Information

Additional Information:

Web-based decision support system for depression nurse care managers This link exits the ClinicalTrials.gov site

Publications:

Fortney JC, Pyne JM, Steven CA, Williams JS, Hedrick RG, Lunsford AK, Raney WN, Ackerman BA, Ducker LO, Bonner LM, Smith JL. A Web-based clinical decision support system for depression care management. Am J Manag Care. 2010 Nov;16(11):849-54.

Responsible Party:	Department of Veterans Affairs
ClinicalTrials.gov Identifier:	NCT00317018 History of Changes
Other Study ID Numbers:	IMV 04-360
Study First Received:	April 19, 2006
Last Updated:	January 27, 2012
Health Authority:	United States: Federal Government

Keywords provided by Department of Veterans Affairs:

depression
quality improvement
implementation
translation
evidence-based practice

collaborative care
adoption
sustainability
cost-effectiveness
rural

Additional relevant MeSH terms:

Depression
Depressive Disorder
Behavioral Symptoms
Mood Disorders
Mental Disorders

ClinicalTrials.gov processed this record on February 09, 2012