A Trial on the Effectiveness of Screening and Brief Problem-Solving Therapy (PST) for Elderly Patients With Psychological Problems
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Purpose
The aim of this study was to determine whether screening followed by brief PSC provided by primary care doctors could improve the quality of life of elderly patients with unrecognized psychological problems in primary care. The following hypotheses were tested:
- Elderly patients screened positive of psychological problems had poorer health-related quality of life (HRQOL) than those who were screened negative.
- Primary care doctors could be trained to provide brief PST.
- Brief PST by a trained primary care doctor could improve the HRQOL of the elderly who were screened positive for psychological problems.
| Condition | Intervention |
|---|---|
|
Undiagnosed Psychological Problems |
Behavioral: problem-solving therapy Behavioral: Video-viewing |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Randomised Controlled Trail on the Effectiveness of Screening and Brief Counselling (Problem-Solving Therapy) for Elderly Patients With Psychological Problems in Primary Care. |
- Health-related quality of life scores [ Time Frame: 6, 12, 26 and 52 weeks ] [ Designated as safety issue: No ]
- Hospital Anxiety & Depression Scale scores [ Time Frame: 6, 12, 26 and 52 weeks ] [ Designated as safety issue: No ]
| Enrollment: | 299 |
| Study Start Date: | November 2002 |
| Study Completion Date: | June 2006 |
| Primary Completion Date: | December 2005 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: problem-solving therapy
Three sessions of brief problem-solving counselling at week 1, 3 and 5 by a family doctor.
|
Behavioral: problem-solving therapy
Three sessions of problem-solving therapy at week 1, 3 and 5.
|
|
Placebo Comparator: viewing video
Three sessions of health education viewing video in groups of 3 to 5 people
|
Behavioral: Video-viewing
Three sessions of viewing health educational videos.
|
Detailed Description:
Design & methods: A prospective single-blind randomised controlled trial (RCT) on 299 patients aged 60 or above without any known psychological diseases but screened positive for psychological problems by the Hospital Anxiety and Depression Scale (HADS). Subjects were randomised to problem-solving (PST) or video-viewing (placebo). All subjects continued with their usual care and were followed up by telephone at 6, 12, 26 and 52 weeks.Changes in SF-36 HRQOL scores, HADS scores and monthly consultation rates at 6, 12, 26 and 52 weeks within groups and between groups.
Eligibility| Ages Eligible for Study: | 60 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Aged 60 or above
- not known to have any psychological problem
- HADS Depression score 6 or above, or Anxiety Score 3 or above
- Written consent to study
Exclusion Criteria:
- known psychological disease diagnosed by a registered doctor
- history of taking any psychotropic drug prescribed by a registered doctor within the last year;
- suicidal plan or strong suicidal thought;
- psychotic symptom;
- impairment in cognitive function; or
- communication problem.
Contacts and Locations| Hong Kong | |
| Two General Outpatient Clinics | |
| Hong Kong, Hong Kong | |
| Principal Investigator: | Cindy L.K. Lam, MD | Family Medicine Unit, Faculty of Medicine, HKU |
More Information
Additional Information:
Publications:
| Responsible Party: | Cindy L.K. Lam, The University of Hong Kong |
| ClinicalTrials.gov Identifier: | NCT00863031 History of Changes |
| Other Study ID Numbers: | HKCTR-497 |
| Study First Received: | March 15, 2009 |
| Last Updated: | March 16, 2009 |
| Health Authority: | Hong Kong: Department of Health |
Keywords provided by The University of Hong Kong:
|
mental health problem-solving therapy elderly |
health-related quality of life primary care Chinese |
ClinicalTrials.gov processed this record on June 17, 2013