Ignite Creation Date:
2024-05-05 @ 11:48 AM
Last Modification Date:
2024-10-26 @ 9:13 AM
Study NCT ID:
NCT00137306
Status:
COMPLETED
Last Update Posted:
2015-04-07
First Post:
2005-08-25
Brief Title:
Facilitating the Adoption of Evidence-Based Depression Management in Substance Use Treatment Programs
Sponsor:
US Department of Veterans Affairs
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Translating Depression Guidelines Into Substance Abuse Treatment
Status:
COMPLETED
Status Verified Date:
2007-02
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Comorbid depression has been consistently linked to worse outcomes for patients in substance abuse treatment programs Practice guidelines recommend pharmacotherapy for comorbid depression if symptoms persist after a 4-week wash-out period for detoxification eg Veterans Health Administration American Psychiatric Association Medications may be considered earlier if a patient has current symptoms and a history of major depressive disorder MDD during periods of sobriety Current efficacy data suggest that antidepressant medication can improve both depression and substance use outcomes among comorbid patients Guideline-concordant use of antidepressant medication for persons with comorbid substance use and depressive disorders however is not routine in many VA substance abuse treatment settings
Detailed Description:
Background
Comorbid depression has been consistently linked to worse outcomes for patients in substance abuse treatment programs Practice guidelines recommend pharmacotherapy for comorbid depression if symptoms persist after a 4-week wash-out period for detoxification eg Veterans Health Administration American Psychiatric Association Medications may be considered earlier if a patient has current symptoms and a history of major depressive disorder MDD during periods of sobriety Current efficacy data suggest that antidepressant medication can improve both depression and substance use outcomes among comorbid patients Guideline-concordant use of antidepressant medication for persons with comorbid substance use and depressive disorders however is not routine in many VA substance abuse treatment settings
Objectives
This study seeks to develop implement and test an organizational intervention in VA substance abuse treatment settings to establish guideline-concordant treatment of comorbid depression The intervention will assist intervention programs in their own implementation of a guidelines-based treatment algorithm to improve the recognition of depression and initiation of pharmacotherapy
Methods
Substance abuse treatment programs in the South Central VISN were matched on program characteristics and current depression management practices n 4 and intervention sites were randomly chosen from each pair Phase 1 now completed of the study analyzed the barriers and facilitators to translation of depression management in participating facilities and used these data to inform the development of the translation intervention its implementation tools and the depression algorithm The translation intervention adopted in this plan was based on the PRECEDE model of organizational behavior change and included provider education use of local champions feedback of screening data and patient educationactivation The depression management algorithm and intervention was developed with input from programs staff and an Advisory Panel of depression management and translation experts Phase 2 of the study implemented and tested the intervention The evaluation in examining program- and provider-level outcomes Program-level outcomes include feasibility extent of adoption of the algorithm and providerorganizational attitudes and beliefs about the interventions design and effectiveness Patient-level outcomes include depressive symptoms substance use outcomes medication adherence quality of life and services use
Status
Phase 1 of the study is complete Phase 2 is near complete
Comorbid depression has been consistently linked to worse outcomes for patients in substance abuse treatment programs Practice guidelines recommend pharmacotherapy for comorbid depression if symptoms persist after a 4-week wash-out period for detoxification eg Veterans Health Administration American Psychiatric Association Medications may be considered earlier if a patient has current symptoms and a history of major depressive disorder MDD during periods of sobriety Current efficacy data suggest that antidepressant medication can improve both depression and substance use outcomes among comorbid patients Guideline-concordant use of antidepressant medication for persons with comorbid substance use and depressive disorders however is not routine in many VA substance abuse treatment settings
Objectives
This study seeks to develop implement and test an organizational intervention in VA substance abuse treatment settings to establish guideline-concordant treatment of comorbid depression The intervention will assist intervention programs in their own implementation of a guidelines-based treatment algorithm to improve the recognition of depression and initiation of pharmacotherapy
Methods
Substance abuse treatment programs in the South Central VISN were matched on program characteristics and current depression management practices n 4 and intervention sites were randomly chosen from each pair Phase 1 now completed of the study analyzed the barriers and facilitators to translation of depression management in participating facilities and used these data to inform the development of the translation intervention its implementation tools and the depression algorithm The translation intervention adopted in this plan was based on the PRECEDE model of organizational behavior change and included provider education use of local champions feedback of screening data and patient educationactivation The depression management algorithm and intervention was developed with input from programs staff and an Advisory Panel of depression management and translation experts Phase 2 of the study implemented and tested the intervention The evaluation in examining program- and provider-level outcomes Program-level outcomes include feasibility extent of adoption of the algorithm and providerorganizational attitudes and beliefs about the interventions design and effectiveness Patient-level outcomes include depressive symptoms substance use outcomes medication adherence quality of life and services use
Status
Phase 1 of the study is complete Phase 2 is near complete
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None