NCT04526067

Brief Summary

The study team will use components of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework to compare Cognitive Adaptation Training (CAT) to Remotely delivered Cognitive Adaptation Training (R-CAT) 1-9 within a managed care organization (MCO), targeting members with serious mental illness (SMI) needing assistance with the regular taking of medication.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
56

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Nov 2020

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

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

First Submitted

Initial submission to the registry

August 21, 2020

Completed
4 days until next milestone

First Posted

Study publicly available on registry

August 25, 2020

Completed
3 months until next milestone

Study Start

First participant enrolled

November 24, 2020

Completed
2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 11, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 11, 2022

Completed
1.8 years until next milestone

Results Posted

Study results publicly available

September 5, 2024

Completed
Last Updated

September 5, 2024

Status Verified

August 1, 2024

Enrollment Period

2 years

First QC Date

August 21, 2020

Results QC Date

April 24, 2024

Last Update Submit

August 29, 2024

Conditions

Keywords

Serious mental illness

Outcome Measures

Primary Outcomes (3)

  • Acceptance of Intervention-Number of Participants Who Dropped Out of Treatment

    Proportion of subjects who dropped out of treatment

    Baseline to 6 months

  • Medication Adherence

    Adherence proportion is calculated as the number of pills missing and presumed taken/ the number of pills prescribed for the time period. Monthly checks will be performed.

    Baseline to 6 months

  • Functional Outcome

    Functional outcome will be rated using the Social and Occupational Functioning Scale (SOFAS).The SOFAS rates functioning on a scale from 0 to 100 based upon all the data collected in the assessment. Higher scores reflect better functional outcome. The value reported is the the 6 month value minus the baseline value\>

    Baseline to 6 months note that repeated measures analysis was also used

Secondary Outcomes (2)

  • Self-Report Habit Index (SRHI)

    Baseline to 6 months (note that repeated measures analysis examined change over time as well.

  • Symptomatology

    Baseline to 6 months

Study Arms (2)

Cognitive Adaptation Training (CAT)

ACTIVE COMPARATOR

A home delivered adherence intervention used by managed care used to improve outcomes across multiple conditions.

Behavioral: CAT

Remote Cognitive Adaptation Training (R-CAT)

ACTIVE COMPARATOR

A primarily remotely delivered workable adherence intervention used by managed care used to improve outcomes across multiple conditions.

Behavioral: R-CAT

Interventions

CATBEHAVIORAL

An evidence-based psychosocial treatment using environmental supports such as signs, alarms, pill containers, and the organization of belongings established in a person's home on weekly visits to cue adaptive behaviors and establish healthy habits.

Also known as: Cognitive Adaptation Training
Cognitive Adaptation Training (CAT)
R-CATBEHAVIORAL

An evidence-based psychosocial treatment using environmental supports such as signs, alarms, pill containers, and the organization of belongings established in a person's home using remote weekly visits to cue adaptive behaviors and establish healthy habits.

Also known as: Remote Cognitive Adaptation Training
Remote Cognitive Adaptation Training (R-CAT)

Eligibility Criteria

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

You may qualify if:

  • Able to give informed consent.
  • Between the ages of 18 and 65.
  • Clinical Diagnosis of Major Depressive Disorder, Bipolar disorder, Schizophrenia, or Schizoaffective Disorder
  • Receiving treatment with oral psychiatric medications.
  • Have had a hospitalization or emergency department visit in the past year
  • Have a Medication Possession Ratio (MPR) based upon electronic refill data below 80% at least 1 of the past 4 quarters with at least 1 psychiatric medication
  • Responsible for taking their own medications
  • Report on telephone prescreen call with researcher team that they have missed at least 2 doses of medication in the past 3 weeks, that they are willing to take medication and would like remote assistance to take medication more regularly
  • Report on telephone prescreen call with research team that they have a stable living environment (individual apartment, family home, board and care facility) within the last three months and no plans to move in the next year
  • Report on prescreen research call with research team that they have no plans to change their MCO in the next 12 months
  • Have a working smart phone
  • Able to understand and complete rating scales and assessments.
  • Agree to home visits for intervention and to count pills and conduct assessments

You may not qualify if:

  • Substance dependence within the past 2 months
  • Currently being treated by an ACT team
  • Documented history of violence or threatening behavior on initial assessment
  • Receive home visits to assist with medication adherence
  • Unable to complete baseline assessments

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Texas Health Science Center - Department of Psychiatry

San Antonio, Texas, 78229, United States

Location

MeSH Terms

Conditions

Depressive Disorder, MajorBipolar DisorderPsychotic DisordersSchizophrenia

Condition Hierarchy (Ancestors)

Depressive DisorderMood DisordersMental DisordersBipolar and Related DisordersSchizophrenia Spectrum and Other Psychotic Disorders

Limitations and Caveats

Not a a randomized trial. Due to the pandemic we were unable to compare groups choosing R-CAT/CAT versus those randomized. We did not get our desired number of participants. Also, some CAT in person treatment had to be conducted outside due to pandemic.

Results Point of Contact

Title
Dawn Velligan, PhD
Organization
University of Texas Health Science Center in San Antonio

Study Officials

  • Dawn Velligan, PhD

    University of Texas Health at San Antonio

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
Those with no preference for CAT or R-CAT will be Randomized, 1:1 done by statistician who has no patient contact through a random allocation program. If blinds are broken accidentally, new raters can be assigned, but blinds are kept by having raters and pill counters unaware of treatment group or study design.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Randomized parallel design
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 21, 2020

First Posted

August 25, 2020

Study Start

November 24, 2020

Primary Completion

November 11, 2022

Study Completion

November 11, 2022

Last Updated

September 5, 2024

Results First Posted

September 5, 2024

Record last verified: 2024-08

Data Sharing

IPD Sharing
Will share

Because this is a research study, we will be unable keep your PHI completely confidential. We may share your health information with people and groups involved in overseeing this research study including: * The National Institute of Mental Health who is funding this study * The following collaborators at other institutions that are involved with the study: Superior Medicaid * The committee that checks the study data on an ongoing basis, to determine if the study should be stopped for any reason. * The members of the local research team * The Institutional Review Board and the Compliance Office of the University of Texas Health Science Center at San Antonio, and other groups that oversee how research studies are carried out.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
Data may be shared with individuals or groups overseeing this project for reporting purposes throughout the study life and after study completion, unidentified participant data will be shared at the time of publication.

Locations