NCT00105820

Brief Summary

In spite of the impact on veteran�s health status and treatment cost, depression is under-diagnosed and under-treated. The goal of this study is to learn how to implement a previously tested, effective collaborative care model for improving the quality of depression care across multiple Veterans Integrated Service Networks (VISNs). To achieve this goal, we are conducting a randomized controlled trial of evidence-based quality improvement (EBQI), a dissemination method that relies on expert design and local implementation of evidence-based practice interventions. We hypothesize that EBQI will result in increased rates of assessment and appropriate management of depression. Results will be useful in designing realistic chronic care programs and performance measures for continuing care improvement.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
750

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jun 2003

Typical duration for not_applicable

Geographic Reach
1 country

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2003

Completed
1.8 years until next milestone

First Submitted

Initial submission to the registry

March 16, 2005

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 17, 2005

Completed
12 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2006

Completed
Last Updated

April 7, 2015

Status Verified

February 1, 2007

First QC Date

March 16, 2005

Last Update Submit

April 6, 2015

Conditions

Major DepressionPTSD

Keywords

EvaluationQuality improvementCluster randomized trialCare modelCollaborative careInformatics

Outcome Measures

Primary Outcomes (1)

  • At set time points the following will be measured: Recovery from depression Patient quality of life 1 year before and after: Clinic depression treatment utilization and costs

Secondary Outcomes (1)

  • Adherence to appropriate treatment

Study Arms (1)

Arm 1

OTHER
Procedure: System level depression care quality improvement

Interventions

System level depression care quality improvementPROCEDURE
Arm 1

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Enrolled as a pt in the VA Healthcare System
  • screens positive for major depression
  • has a scheduled visit at a primary care site taking part in the study

You may not qualify if:

  • severe alcohol abuse
  • psychosis
  • dementia
  • acutely suicidal (at screening)
  • lack of access to or ability to use a phone

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

VA Greater Los Angeles Healthcare System, Sepulveda, CA

Sepulveda, California, 91343, United States

Location

Louis Stokes VA Medical Center, Cleveland, OH

Cleveland, Ohio, 44106, United States

Location

VA Puget Sound Health Care System Seattle Division, Seattle, WA

Seattle, Washington, 98108, United States

Location

Related Publications (14)

  • Felker BL, Barnes RF, Greenberg DM, Chaney EF, Shores MM, Gillespie-Gateley L, Buike MK, Morton CE. Preliminary outcomes from an integrated mental health primary care team. Psychiatr Serv. 2004 Apr;55(4):442-4. doi: 10.1176/appi.ps.55.4.442.

    PMID: 15067160RESULT

  • Kanter JW, Epler AJ, Chaney EF, Liu CF, Heagerty P, Lin P, Felker B, Hedrick SC. Comparison of 3 Depression Screening Methods and Provider Referral in a Veterans Affairs Primary Care Clinic. Prim Care Companion J Clin Psychiatry. 2003 Dec;5(6):245-250. doi: 10.4088/pcc.v05n0601.

    PMID: 15213794RESULT

  • Felker BL, Chaney E, Rubenstein LV, Bonner LM, Yano EM, Parker LE, Worley LL, Sherman SE, Ober S. Developing effective collaboration between primary care and mental health providers. Prim Care Companion J Clin Psychiatry. 2006;8(1):12-6. doi: 10.4088/pcc.v08n0102.

    PMID: 16862248RESULT

  • Fortney JC, Steffick DE, Burgess JF Jr, Maciejewski ML, Petersen LA. Are primary care services a substitute or complement for specialty and inpatient services? Health Serv Res. 2005 Oct;40(5 Pt 1):1422-42. doi: 10.1111/j.1475-6773.2005.00424.x.

    PMID: 16174141RESULT

  • Chaney E, Rabuck LG, Uman J, Mittman DC, Simons C, Simon BF, Ritchie M, Cody M, Rubenstein LV. Human subjects protection issues in QUERI implementation research: QUERI Series. Implement Sci. 2008 Feb 15;3:10. doi: 10.1186/1748-5908-3-10.

    PMID: 18279507RESULT

  • Campbell DG, Felker BL, Liu CF, Yano EM, Kirchner JE, Chan D, Rubenstein LV, Chaney EF. Prevalence of depression-PTSD comorbidity: implications for clinical practice guidelines and primary care-based interventions. J Gen Intern Med. 2007 Jun;22(6):711-8. doi: 10.1007/s11606-006-0101-4.

    PMID: 17503104RESULT

  • Liu CF, Bolkan C, Chan D, Yano EM, Rubenstein LV, Chaney EF. Dual use of VA and non-VA services among primary care patients with depression. J Gen Intern Med. 2009 Mar;24(3):305-11. doi: 10.1007/s11606-008-0867-7. Epub 2008 Dec 20.

    PMID: 19101777RESULT

  • Waltz TJ, Campbell DG, Kirchner JE, Lombardero A, Bolkan C, Zivin K, Lanto AB, Chaney EF, Rubenstein LV. Veterans with depression in primary care: provider preferences, matching, and care satisfaction. Fam Syst Health. 2014 Dec;32(4):367-77. doi: 10.1037/fsh0000071. Epub 2014 Aug 4.

    PMID: 25090611RESULT

  • Lombardero A, Campbell DG, Harris KJ, Chaney EF, Lanto AB, Rubenstein LV. Prevalence and correlates of smoking status among veterans affairs primary care patients with probable major depressive disorder. Addict Behav. 2014 Mar;39(3):538-45. doi: 10.1016/j.addbeh.2013.10.030. Epub 2013 Nov 4.

    PMID: 24290879RESULT

  • Bolkan CR, Bonner LM, Campbell DG, Lanto A, Zivin K, Chaney E, Rubenstein LV. Family involvement, medication adherence, and depression outcomes among patients in veterans affairs primary care. Psychiatr Serv. 2013 May 1;64(5):472-8. doi: 10.1176/appi.ps.201200160.

    PMID: 23370463RESULT

  • Bonner LM, Lanto AB, Bolkan C, Watson GS, Campbell DG, Chaney EF, Zivin K, Rubenstein LV. Help-seeking from clergy and spiritual counselors among veterans with depression and PTSD in primary care. J Relig Health. 2013 Sep;52(3):707-18. doi: 10.1007/s10943-012-9671-0.

    PMID: 23297184RESULT

  • Yano EM, Chaney EF, Campbell DG, Klap R, Simon BF, Bonner LM, Lanto AB, Rubenstein LV. Yield of practice-based depression screening in VA primary care settings. J Gen Intern Med. 2012 Mar;27(3):331-8. doi: 10.1007/s11606-011-1904-5.

    PMID: 21975821RESULT

  • Zivin K, Campbell DG, Lanto AB, Chaney EF, Bolkan C, Bonner LM, Miller EM, Valenstein M, Waltz TJ, Rubenstein LV. Relationships between mood and employment over time among depressed VA primary care patients. Gen Hosp Psychiatry. 2012 Sep-Oct;34(5):468-77. doi: 10.1016/j.genhosppsych.2012.05.008. Epub 2012 Jul 6.

    PMID: 22771108RESULT

  • Chaney EF, Rubenstein LV, Liu CF, Yano EM, Bolkan C, Lee M, Simon B, Lanto A, Felker B, Uman J. Implementing collaborative care for depression treatment in primary care: a cluster randomized evaluation of a quality improvement practice redesign. Implement Sci. 2011 Oct 27;6:121. doi: 10.1186/1748-5908-6-121.

    PMID: 22032247RESULT

MeSH Terms

Conditions

Depressive Disorder, MajorStress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Depressive DisorderMood DisordersMental DisordersStress Disorders, TraumaticTrauma and Stressor Related Disorders

Study Officials

  • Edmund F. Chaney, PhD

    VA Puget Sound Health Care System Seattle Division, Seattle, WA

    PRINCIPAL INVESTIGATOR

  • Lisa V. Rubenstein, MD MSPH

    VA Greater Los Angeles Healthcare System, Sepulveda, CA

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Intervention Model
PARALLEL
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 16, 2005

First Posted

March 17, 2005

Study Start

June 1, 2003

Study Completion

March 1, 2006

Last Updated

April 7, 2015

Record last verified: 2007-02

Locations

US(3)