Improving Depression Management Through Peer Support (DIAL-UP)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Department of Veterans Affairs
ClinicalTrials.gov Identifier:
NCT00777205
First received: October 21, 2008
Last updated: April 16, 2014
Last verified: April 2014
  Purpose

We will conduct a randomized controlled trial (RCT) that compares the effectiveness of a telephone delivered, recovery focused, peer-support intervention to enhanced usual care for VA patients with depression.


Condition Intervention
Depression
Behavioral: Telephone Peer Support
Behavioral: Enhanced Usual Care

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Supportive Care
Official Title: Improving Depression Management Through Peer Support

Further study details as provided by Department of Veterans Affairs:

Primary Outcome Measures:
  • Functional Status, Quality of Life, Suicidality, Depressive Symptoms, Recovery Focus [ Time Frame: Baseline, 3 months, 6 months, 12 months ] [ Designated as safety issue: No ]

Enrollment: 443
Study Start Date: February 2010
Study Completion Date: September 2013
Primary Completion Date: September 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Arm 1
Telephone-based peer support
Behavioral: Telephone Peer Support
Patients in the DIAL-UP intervention arm will receive their usual mental health care, a copy of the Depression Helpbook by Wayne Katon and bi-weekly study mailings with depression management tips plus a) a peer-support manual that outlines self-management and recovery principles and provides peer discussion topics and b) access to a specialized telephone platform that permits free calls to their partners, ready access to mental health staff for back-up and advice on being effective partners, and recorded tips on depression management.
Behavioral: Enhanced Usual Care
Patients in the enhanced usual care arm will receive their usual mental health care, a copy of the Depression Helpbook by Wayne Katon and bi-weekly study mailings with depression management tips.
Active Comparator: Arm 2
Enhanced Usual Care
Behavioral: Enhanced Usual Care
Patients in the enhanced usual care arm will receive their usual mental health care, a copy of the Depression Helpbook by Wayne Katon and bi-weekly study mailings with depression management tips.

Detailed Description:

Peer-support interventions have been recommended by prestigious national task forces and incorporated into the VA Comprehensive Mental Health Strategic Plan. Patients who cope with longer term depressive symptoms may benefit from these interventions. An adequately powered study that examines the effectiveness of a feasible peer-support intervention for VA patients with depression will inform leaders who are considering implementing peer-support initiatives. If successful in improving outcomes, this intervention would be an important addition to the services offered to VA patients with depression.

Although effective treatments are available for depression, remission is often incomplete and relapse is common. Thus, many patients must cope with longer term depressive symptoms that decrease their quality of life and compromise functioning. As with other chronic conditions, frequent, proactive, and supportive contacts may assist depressed patients in maintaining the motivation and self-management skills needed to reach valued life goals despite continuing symptoms.

Peer-support interventions that supplement usual mental health care, allow for frequent contacts, build on key elements of chronic illness care, mutual self-help, and recovery may be beneficial for patients dealing with depressive symptoms over the longer term.

In this study, each participant will be matched with another participating veteran and the pairs randomized to enhanced usual care or to the telephone based peer-support intervention (DIAL-UP). All study participants will receive usual care plus in-person training and written materials outlining depression self-management strategies, behavioral activation, and recovery. DIAL-UP participants will also receive: a) a peer-support manual that outlines these principles and provides peer discussion topics and b) access to a specialized telephone platform that permits free calls to their partners, ready access to mental health staff for back-up and advice, and recorded tips on depression management. Patients will be encouraged to call their partners at least once per week during the 6-month intervention period. Patient outcomes will be assessed at 3, 6, and 12 months following enrollment.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • currently in treatment at Ann Arbor, Detroit, Battle Creek, or Saginaw VA
  • not receiving formal mental health services or regularly attending mutual self-help programs outside of the VA
  • diagnosis of a depressive disorder in the last 24 months that is confirmed by the relevant clinician
  • prescription and initiation of a psychotherapy and/or antidepressant trial
  • are being seen less than bi-weekly by clinicians for psychiatric or substance use disorders
  • have a current PHQ-9 scores > 10 or WSAS scores > 10
  • have stable access to and ability to communicate by telephone

Exclusion Criteria:

  • diagnosis of schizophrenia, schizoaffective disorder, MDD with psychotic features, or Bipolar I in the past 24 months. Diagnosis of active substance dependence in the past 12 months or substance abuse in the last 6 months
  • an immediate risk of suicide, requiring hospitalization or urgent evaluation
  • clinician assessment that participation in the study could have an adverse impact on the patient or his/her partner.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00777205

Locations
United States, Michigan
VA Ann Arbor Healthcare System
Ann Arbor, Michigan, United States, 48113-0170
VA Medical Center, Battle Creek
Battle Creek, Michigan, United States, 49015
John D. Dingell VA Medical Center, Detroit
Detroit, Michigan, United States, 48201
Aleda E. Lutz VA Medical Center
Saginaw, Michigan, United States, 48602
Sponsors and Collaborators
Investigators
Principal Investigator: Marcia T. Valenstein, MD AB VA Ann Arbor Healthcare System
  More Information

Publications:
Responsible Party: Department of Veterans Affairs
ClinicalTrials.gov Identifier: NCT00777205     History of Changes
Other Study ID Numbers: IIR 08-325
Study First Received: October 21, 2008
Last Updated: April 16, 2014
Health Authority: United States: Federal Government

Keywords provided by Department of Veterans Affairs:
Peer Support
Quality of Life
Telephone

Additional relevant MeSH terms:
Depression
Depressive Disorder
Behavioral Symptoms
Mood Disorders
Mental Disorders

ClinicalTrials.gov processed this record on September 18, 2014