By: ifood.tv

Telemedicine for Depression in Primary Care

Oct 05, 2012 No Comments by

Background: In Italy, several recent studies found that a large percentage of patients
attending Primary Care (PC) clinics meet criteria for at least one common mental disorder,
as they show high rates of depression, anxiety, and co-morbid anxiety and depression. These
patients may experience significant functional impairment and suffer from unexplained
somatic symptoms, and often remain undetected and untreated. Consistent evidence for the
effectiveness of organized care programs for depression, by improving quality of care and
treatment adherence, is now available. Fundamental elements of these programs include
algorithms to prompt the proper and timely implementation of evidence-based treatments,
structured outcome assessment and systematic outreach. Telemedicine tools may represent a
valuable strategy for improving depression outcomes in PC.

Aims: 1.To develop and employ computer-based assessment to more accurately and timely detect
patient depression in PC settings; 2.To evaluate the feasibility and effectiveness of a care
support program developed in conjunction with the PC-based assessment for patients suffering
from depression, as based on two main objectives: 2a.To support GP decisions with treatment
algorithms and improve the quality of GP and mental health service collaboration; 2b.To
improve patient compliance and treatment adherence by using appropriate telecommunication
tools and technologically advanced tools to conduct systematic routine assessment. Although
much of this system will be computer-based, live telephonic and in-person contacts will also
be included as needed.

Study Design: The study is a randomized controlled trial, involving four PC group clinics
(GCs) located in two areas of Northern Italy. Two PC clinics will use the experimental
protocol; the other two will serve as controls.

The study will compare two different conditions:

– Group 1 (experimental): GPs will use a Computer Decision Support System with treatment
algorithms and advice and supervision from a consultant psychiatrist. Patients will
receive reminders via mobile texting or automatic mobile (or landline) phone calls to
improve adherence to the treatment prescribed.

– Group 2 (control): GPs will provide TAU, will make their own decisions and will
therefore not use the CDSS. Patients will not receive any reminders. All enrolled
patients will be administered and will fill in the IDS-SR at baseline, 3 and 6-months:
the IDS-SR score will be used as a primary endpoint.

Clinical Trial Conditions: Depression

Treatments in this Clinical Trial : Computerized Decision Support System

Eligible Clinical Trial Participant Age : Between 18 years to 65 years

Can Healthy Volunteers Participate: No

Clinical Trial Lead Sponsor: IRCCS Centro San Giovanni di Dio Fatebenefratelli

Detailed Clinical Trial Description: Background: In Italy, several recent studies found that a large percentage of patients
attending Primary Care (PC) clinics meet criteria for at least one common mental disorder,
as they show high rates of depression, anxiety, and co-morbid anxiety and depression. These
patients may experience significant functional impairment and suffer from unexplained
somatic symptoms, and often remain undetected and untreated. Consistent evidence for the
effectiveness of organized care programs for depression, by improving quality of care and
treatment adherence, is now available. Fundamental elements of these programs include
algorithms to prompt the proper and timely implementation of evidence-based treatments,
structured outcome assessment and systematic outreach. Telemedicine tools may represent a
valuable strategy for improving depression outcomes in PC.

Aims: 1.To develop and employ computer-based assessment to more accurately and timely detect
patient depression in PC settings; 2.To evaluate the feasibility and effectiveness of a care
support program developed in conjunction with the PC-based assessment for patients suffering
from depression, as based on two main objectives: 2a.To support GP decisions with treatment
algorithms and improve the quality of GP and mental health service collaboration; 2b.To
improve patient compliance and treatment adherence by using appropriate telecommunication
tools and technologically advanced tools to conduct systematic routine assessment. Although
much of this system will be computer-based, live telephonic and in-person contacts will also
be included as needed.

Study Design: The study is a randomized controlled trial, involving four PC group clinics
(GCs) located in two areas of Northern Italy. Two PC clinics will use the experimental
protocol; the other two will serve as controls.

The study will compare two different conditions:

– Group 1 (experimental): GPs will use a Computer Decision Support System with treatment
algorithms and advice and supervision from a consultant psychiatrist. Patients will
receive reminders via mobile texting or automatic mobile (or landline) phone calls to
improve adherence to the treatment prescribed.

– Group 2 (control): GPs will provide TAU, will make their own decisions and will
therefore not use the CDSS. Patients will not receive any reminders. All enrolled
patients will be administered and will fill in the IDS-SR at baseline, 3 and 6-months:
the IDS-SR score will be used as a primary endpoint.

The clinical trial information was obtained from http://clinicaltrials.gov/ct2/show/NCT01701791

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By: ifood.tv