Evaluation of the Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Program

NCT04839718 | Withdrawn

• 1 other identifier: 1421043
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Depression and anxiety are increasingly common conditions for which primary care providers (PCPs) serve as the initial healthcare contact for most patients. Comorbid depression and anxiety result in higher costs, and treatment as usual, which is referrals to specialty psychiatric care, often contribute to delays in care. Collaborative psychiatric care is an evidence-based strategy to increase mental healthcare access while reducing costs. ADAPT is a novel collaborative care model. By using technology-driven appointments with providers, ADAPT increases access to mental healthcare, and reduces member wait times. This mixed methods study will assess implementation measures of the ADAPT program and the components of ADAPT related to patient mental health improvement compared to specialty mental health care. The hypothesis is that: ADAPT program will have good program reach and efficacy. We will examine program implementation and maintenance. Further, the study looks to uncover member and program characteristics that are associated with depression and anxiety remission and care utilization.

Conditions

Depression; Anxiety

Keywords

Depression; Anxiety

Outcome Measures

Primary Outcomes (1)

• Patient reach

  Examine and compare patients eligible and enrolled in ADAPT versus those eligible but not enrolled in ADAPT

  through study completion, 2 years

Secondary Outcomes (14)

• Member characteristics associated with depression remission

  baseline, 3 and 6 months

• Member characteristics associated with anxiety remission

  baseline, 3 and 6 months

• Efficacy: Patient therapy engagement

  baseline, 3 and 6 months

• Efficacy: Patient medication provider engagement

  baseline, 3 and 6 months

• Efficacy: Patient medication engagement

  baseline, 3 and 6 months

Study Arms (2)

Control

Patients receiving referral to specialty mental healthcare

ADAPT

ADAPT

Behavioral: ADAPT

Interventions

ADAPT BEHAVIORAL

The Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Program is a novel collaborative psychiatric care model that is designed to unburden PCPs and psychiatrists, increase access to quality specialty mental healthcare for Kaiser Permanente members, and improve patient depression and anxiety treatment outcomes by utilizing technology-driven appointments. This program uses principles of collaborative care, including patient-centered care, population-based care, evidence-based care, measurement-based treatment to target, and accountable care.

ADAPT

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Kaiser Permanente Northern California adult members who screen positive for depression or anxiety in primary care and are referred to treatment.

You may qualify if:

• Adult Outcomes Questionnaire (AOQ) score between 10-30
• English-Speaking

You may not qualify if:

• High risk for suicide defined by answer to question 9 on PHQ-9 of 1 or more
• Diagnosis of bipolar disorder
• Diagnosis of a psychotic disorder
• Dementia diagnosis
• Active substance use disorder diagnosis
• Current hospice
• Current home-based palliative care
• Residing in a skilled nursing facility
• Residing in an assisted living facility
• Non-Kaiser Permanente Member
• Established psychiatric care outside of Kaiser Permanente

Sponsors & Collaborators

• Kaiser Permanente: lead

Study Sites (1)

Kaiser Permanente Northern California Division of Research

Oakland, California, 94612, United States

Location

MeSH Terms

Conditions

Depression; Anxiety Disorders

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Mental Disorders

Study Officials

• Kathryn K Erickson-Ridout, MD PhD

  Kaiser Permanente

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: ECOLOGIC OR COMMUNITY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 29, 2021
• First Posted: April 9, 2021
• Study Start: April 1, 2019
• Primary Completion: December 31, 2022
• Study Completion: December 31, 2022
• Last Updated: March 2, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)