Training Doctors to Support Patient Self-Care of Depression

NCT01618552 | Completed DMC

• 2 other identifiers: 2012336397-1R34MH095893
• Study Type: interventional
• Target: 182
• Locations: 1 country
• Sites: 2

Brief Summary

This study will determine whether practicing primary care providers (PCPs) can be trained to support patient self-care of depression and co-existing diabetes during office visits, and begin to explore whether this might improve depression and diabetes outcomes, and whether the effects of the training generalize to patients with health conditions other than depression and diabetes. This is important because most patients with chronic conditions struggle with self-care and are seen in primary care, yet PCPs are seldom trained to support self-care.

Conditions

Depression; Diabetes

Keywords

Chronic disease; Cluster randomization; Comorbidity; Depression; Diabetes; Medical history taking; Office visits; Patient acceptance of health care; Patient compliance; Patient simulation; Physician patient relations; Primary health care; Randomized controlled trials; Self care; Self efficacy

Outcome Measures

Primary Outcomes (1)

• Physician use of self-efficacy enhancing interviewing techniques

  During the 3 months after receiving intervention

Secondary Outcomes (15)

• Patient self-efficacy for depression self-care

  5 minutes after an index visit with primary provider

• Patient self-efficacy for diabetes self-care

  5 minutes after an index visit with primary provider

• General self-care self-efficacy (all health conditions)

  5 minutes after an index visit with primary provider

• Patient depressive symptoms

  3 months after an index visit with their primary care provider

• Patient depression self-care behaviors

  3 months after an index visit with their primary care provider

Study Arms (2)

SEE IT training (interviewing skills)

EXPERIMENTAL

Intervention to train primary care physicians in the use of self-efficacy enhancing interviewing techniques (SEE IT) with patients who have coexisting depression and diabetes

Behavioral: SEE IT training

Control (knowledge enhancement)

ACTIVE COMPARATOR

Brief video clip designed to increase primary care physician awareness of new medication treatments for patients with diabetes

Other: Knowledge enhancement

Interventions

SEE IT training BEHAVIORAL

Standardized patient instructors provide a scripted intervention to train primary care physicians in the use of self-efficacy enhancing interviewing techniques (SEE IT) during office visits with patients who have coexisting depression and diabetes

SEE IT training (interviewing skills)

Knowledge enhancement OTHER

Brief video clip designed to increase primary care physician awareness of new medication treatments for diabetes

Control (knowledge enhancement)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Currently in practice at a participating office within one of the 2 participating health systems (University of California Davis Primary Care Network, Sutter Sacramento Health System)
• Trained as a family physician, general practitioner, and/or general internist
• Able to read and speak English
• Receive primary health care in one of the participating offices, from one of the participating primary care physicians
• Aged 18 years or older
• Able to read and speak English
• Self-report of adequate vision, hearing, and hand function to complete self-administered questionnaires on a touch screen notebook computer
• Have concurrent diagnoses of depression and diabetes, determined via medical record review
• Have at least mild depressive symptoms, manifested by a score of 10 or greater on a telephone-administered Patient Health Questionnaire (PHQ-9).
• Have an office visit scheduled with their assigned primary care provider within 1 month of study eligibility screening
• Made 2 or more of their primary care office visits during the preceding year with their assigned primary care provider
• Receive primary health care in one of the participating offices, from one of the participating primary care physicians
• Aged 18 years or older
• Able to read and speak English
• Self-report of adequate vision, hearing, and hand function to complete self-administered questionnaires on a touch screen notebook computer

You may not qualify if:

• Self-report or medical record evidence of unstable overall medical status
• Self-report or medical record evidence of terminal illness
• Self-report or medical record evidence of bipolar disorder, chronic psychosis (schizophrenia or other), or personality disorder
• Self-report or medical record evidence of a history of attempted suicide
• Planned transfer of care to a health system other than the 2 participating systems within 6 months
• Inability to understand any of the screening questions, after appropriate explanation (e.g. due to cognitive impairment, developmental delay, or other reasons)

Sponsors & Collaborators

• University of California, Davis: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (2)

Sutter Health Sacramento

Sacramento, California, 95816, United States

Location

University of California Davis Health System

Sacramento, California, 95817, United States

Location

Related Publications (2)

• Jerant A, Kravitz RL, Azari R, White L, Garcia JA, Vierra H, Virata MC, Franks P. Training residents to employ self-efficacy-enhancing interviewing techniques: randomized controlled trial of a standardized patient intervention. J Gen Intern Med. 2009 May;24(5):606-13. doi: 10.1007/s11606-009-0946-4. Epub 2009 Mar 19.

  PMID: 19296179 BACKGROUND

• Jerant A, Kravitz RL, Tancredi D, Paterniti DA, White L, Baker-Nauman L, Evans-Dean D, Villarreal C, Ried L, Hudnut A, Franks P. Training Primary Care Physicians to Employ Self-Efficacy-Enhancing Interviewing Techniques: Randomized Controlled Trial of a Standardized Patient Intervention. J Gen Intern Med. 2016 Jul;31(7):716-22. doi: 10.1007/s11606-016-3644-z. Epub 2016 Mar 8.

  PMID: 26956140 DERIVED

MeSH Terms

Conditions

Depression; Diabetes Mellitus; Chronic Disease; Patient Acceptance of Health Care; Patient Compliance

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Treatment Adherence and Compliance; Health Behavior

Study Officials

• Anthony Jerant, MD

  University of California, Davis

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 8, 2012
• First Posted: June 13, 2012
• Study Start: April 1, 2013
• Primary Completion: February 1, 2015
• Study Completion: May 1, 2015
• Last Updated: December 2, 2015

Record last verified: 2015-11

Locations

US (2)