Determining Depression Treatment Preferences of Low-Income Latinos in Primary Care Settings

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Isabel T. Lagomasino, MD, MSHS, University of Southern California
ClinicalTrials.gov Identifier:
NCT00260169
First received: November 29, 2005
Last updated: December 9, 2013
Last verified: December 2013

November 29, 2005
December 9, 2013
November 2005
October 2007   (final data collection date for primary outcome measure)
Depression treatment preferences as measured by a conjoint analysis survey and qualitative interviews [ Time Frame: Measured at Week 16 ] [ Designated as safety issue: No ]
Depression treatment preferences as measured by a conjoint analysis survey and qualitative interviews; measured at Week 16
Complete list of historical versions of study NCT00260169 on ClinicalTrials.gov Archive Site
Depression outcomes as measured by the Patient Health Questionnaire-9 [ Time Frame: Measured at Week 16 ] [ Designated as safety issue: No ]
Depression outcomes as measured by the Patient Health Questionnaire-9; measured at Week 16
Not Provided
Not Provided
 
Determining Depression Treatment Preferences of Low-Income Latinos in Primary Care Settings
Patient-Centered Depression Care in the Public Sector

This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos.

Depression is a serious illness that is difficult to diagnose and treat, especially in populations that underutilize mental health services. The Latino population is one such group. Accommodating patient preferences for care, provider capacities, and administrator priorities is essential to the development of effective depression care interventions that are sustainable in public sector systems. However, little is understood regarding the depression treatment preferences of low-income Latinos who have not received quality depression care and who may not feel that they can voice their opinions about their health care. In addition, little is known about the preferences, capabilities, and priorities of providers and administrators in primary care clinics. This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos. The study will also evaluate the effectiveness of various treatments in reducing depression.

Following baseline assessments of depression treatment preferences and resources, participants in this open label study will be randomly assigned to receive collaborative care either immediately or after a waiting period. Individuals assigned to receive immediate care will undergo treatment for 12 weeks. Other participants will receive treatment at a later time. All participants will have the option to receive one of the following treatments: (1) medication management from the Depression Care Specialist (DCS) and antidepressant medication from their primary care provider (PCP); (2) cognitive-behavioral therapy from the DCS; or (3) a combination of both treatments. Depression treatment outcomes and preferences will be measured post-intervention. Provider and administrator preferences will also be measured post-intervention and potential strategies for implementing patient-centered depression care programs will be identified.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Depression
  • Behavioral: Collaborative care treatment
    Patients receiving collaborative care treatment choose 12 weeks of CBT and/or medication management (antidepressants prescribed by patients' primary care provider) from the study depression care specialist (DCS).
  • Behavioral: Enhanced usual care
    Usual care participants are assigned to a 16-week wait-list for the study treatment, during which they are free to receive treatment elsewhere. A letter is given to participants' primary care providers (PCP) that indicates they screened positive for depression. In addition, patients receive an information booklet about depression and a community resource list.
  • Experimental: 1
    Participants will receive collaborative care
    Intervention: Behavioral: Collaborative care treatment
  • Active Comparator: 2
    Participants will receive enhanced usual care
    Intervention: Behavioral: Enhanced usual care
Dwight-Johnson M, Lagomasino IT, Hay J, Zhang L, Tang L, Green JM, Duan N. Effectiveness of collaborative care in addressing depression treatment preferences among low-income Latinos. Psychiatr Serv. 2010 Nov;61(11):1112-8. doi: 10.1176/appi.ps.61.11.1112.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
432
January 2009
October 2007   (final data collection date for primary outcome measure)

Inclusion Criteria:

For Participating Patients:

  • Attending one of the study clinics for primary care
  • English or Spanish-speaking
  • Screens positive for major depressive disorder or dysthymia

For Providers:

  • All primary care providers providing at least one day of services at one of the study clinics

For Administrators:

  • Administrative, medical, and nursing directors from each study site and directors of affiliated local mental health clinics

Exclusion Criteria:

For Participating Patients:

  • Acutely suicidal
  • Screens positive for bipolar disorder, psychotic disorder, or cognitive impairment
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00260169
R01 MH067949, R01MH067949, DSIR 82-SEPC
Not Provided
Isabel T. Lagomasino, MD, MSHS, University of Southern California
University of Southern California
National Institute of Mental Health (NIMH)
Principal Investigator: Isabel T. Lagomasino, MD, MSHS University of Southern California
Principal Investigator: Megan Dwight-Johnson, MD, MPH VA Medical Center-West Los Angeles
University of Southern California
December 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP