Standardized Versus Tailored Implementation of Measurement Based Care for Depression
iMBC
1 other identifier
interventional
382
1 country
6
Brief Summary
Depression remains among the nation's top 10 chronic illnesses, costing over $80 billion annually; however, Measurement Based Care (MBC) is a relatively simple evidence-based intervention framework that has been shown to improve outcomes for depressed clients by identifying those who are not making progress and reducing the likelihood that clients will deteriorate in treatment. Despite the demonstrated effectiveness of MBC, the majority of community mental health counselors do not regularly assess target problem symptoms to guide their work. This study will test a standardized versus a tailored approach to implementing MBC that will include the integration of symptom monitoring capacities into the electronic health record system of one of the nation's largest not-for-profit providers of behavioral health services.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable depression
Started Jun 2015
Longer than P75 for not_applicable depression
6 active sites
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
First Submitted
Initial submission to the registry
October 12, 2014
CompletedFirst Posted
Study publicly available on registry
October 16, 2014
CompletedStudy Start
First participant enrolled
June 1, 2015
CompletedPrimary Completion
Last participant's last visit for primary outcome
October 18, 2019
CompletedStudy Completion
Last participant's last visit for all outcomes
November 15, 2019
CompletedResults Posted
Study results publicly available
June 2, 2023
CompletedJune 2, 2023
May 1, 2023
4.4 years
October 12, 2014
February 7, 2022
May 4, 2023
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Patient Health Questionnaire
Patient Health Questionnaire-9 (PHQ-9): screening tool for depression that can be used to monitor symptom change over time and inform care. Minimum value: 0 Maximum value: 27 Higher scores indicate a greater severity of depression (i.e., worse outcome).
Week 0 (baseline) and Week 12 of treatment
PHQ-9 Completed Fidelity
PHQ-9 fidelity was monitored for each individual psychotherapy session. Fidelity was scored as: (1) Therapist did not complete or record any PHQ-9 scores; (2) Therapist completed PHQ-9 and recorded scores in the EHR only; or (3) Therapist completed PHQ-9, recorded scores in the EHR, and discussed scores with the patient. The unit of measure is the number individual psychotherapy sessions conducted during the 5-month implementation window. Patient data were included for any patient at least 18 years old at the time of their first session with a participating therapist, regardless of if the patient was enrolled in the study.
5-month implementation window
Study Arms (4)
Standardized Implementation, Patients
EXPERIMENTALSites in standardized condition arm will receive the standard implementation of measurement-based care intervention (PHQ-9).
Tailored Implementation, Patients
EXPERIMENTALSites in the tailored condition arm will receive the tailored implementation of measurement-based care intervention (PHQ-9).
Standardized Implementation, Therapists
EXPERIMENTALSites randomized to the standardized condition will be expected to use the measurement-based care intervention (PHQ-9) prior to each session with a depressed client and they will work as a team to maximize fidelity.
Tailored Implementation, Therapists
EXPERIMENTALSites randomized to the tailored condition will develop a site-specific protocol for use of the measurement-based care intervention (PHQ-9), and they will work as a team to maximize the fit of measurement-based care to this clinic.
Interventions
Measurement-based care in this study is the practice of basing psychotherapeutic services on the results of the Patient Health Questionnaire; the implementation of measurement-based care will be tailored based on clinic specific barriers and facilitators.
Measurement-based care in this study is the practice of basing psychotherapeutic services on the results of the Patient Health Questionnaire (PHQ-9); the implementation of measurement-based care will be standardized such that clinicians will be encouraged to administer the PHQ-9 to depressed clients before each session.
Eligibility Criteria
You may qualify if:
- be a practicing clinician at Centerstone; and
- see at least one adult (18+) patient
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (6)
Centerstone Connersville
Connersville, Indiana, 47331, United States
Centerstone Martinsville
Martinsville, Indiana, 46151, United States
Centerstone Columbia
Columbia, Tennessee, 38401, United States
Centerstone Dede Wallace Campus
Nashville, Tennessee, 37204, United States
Centerstone Frank Luton Center
Nashville, Tennessee, 37217, United States
Centerstone Tullahoma
Tullahoma, Tennessee, 37388, United States
Related Publications (4)
Snider MDH, Boyd MR, Walker MR, Powell BJ, Lewis CC. Using audit and feedback to guide tailored implementations of measurement-based care in community mental health: a multiple case study. Implement Sci Commun. 2023 Aug 14;4(1):94. doi: 10.1186/s43058-023-00474-8.
PMID: 37580815DERIVEDLewis CC, Boyd MR, Marti CN, Albright K. Mediators of measurement-based care implementation in community mental health settings: results from a mixed-methods evaluation. Implement Sci. 2022 Oct 21;17(1):71. doi: 10.1186/s13012-022-01244-1.
PMID: 36271404DERIVEDAlbright K, Navarro EI, Jarad I, Boyd MR, Powell BJ, Lewis CC. Communication strategies to facilitate the implementation of new clinical practices: a qualitative study of community mental health therapists. Transl Behav Med. 2022 Feb 16;12(2):324-334. doi: 10.1093/tbm/ibab139.
PMID: 34791490DERIVEDLewis CC, Scott K, Marti CN, Marriott BR, Kroenke K, Putz JW, Mendel P, Rutkowski D. Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol. Implement Sci. 2015 Sep 7;10:127. doi: 10.1186/s13012-015-0313-2.
PMID: 26345270DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Results Point of Contact
- Title
- Dr. Cara C. Lewis
- Organization
- Kaiser Permanente Washington Health Research Institute
Study Officials
- PRINCIPAL INVESTIGATOR
Cara C Lewis, PhD
Indiana University
Publication Agreements
- PI is Sponsor Employee
- Yes
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- OTHER
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Investigator
Study Record Dates
First Submitted
October 12, 2014
First Posted
October 16, 2014
Study Start
June 1, 2015
Primary Completion
October 18, 2019
Study Completion
November 15, 2019
Last Updated
June 2, 2023
Results First Posted
June 2, 2023
Record last verified: 2023-05
Data Sharing
- IPD Sharing
- Will not share