At a glance
ClinicalIndex Comparison Record- ✓Confirmed COPD by American Thoracic Society criteria
- ✓Major depression diagnosed by DSM-IV criteria
- ✓Hamilton depression rating scale score >14
- ✓English speaking
- ✕Unable to give informed consent
- ✕MiniMental score <24 (cognitive impairment)
- ✕Aphasia
- ✕Nursing home placement after discharge
Standardized by ClinicalIndex from the ClinicalTrials.gov record · verify against the source.
Treatment Effectiveness in Depressed Patients With Chronic Obstructive Pulmonary Disease
In Brief
A clinical study evaluating Treatment Adherence Intervention and Enhanced Care for Pulmonary Disease, Chronic Obstructive and Major Depression. Completed, enrolled 141 participants across 3 sites.
Detailed Summary
Approximately 20% of patients with chronic obstructive pulmonary disease (COPD) have major depression, a condition that contributes to suffering but also to poor treatment adherence leading to increased disability and morbidity. This study investigates the effectiveness of a care management intervention aimed at facilitating adherence to a treatment algorithm based on the Agency for Health Care Policy and Research (AHCPR) guidelines. The investigators hypothesize that this intervention, in comparison to usual care, will increase the prescription of adequate antidepressant treatment by physicians, enhance treatment adherence by patients, and reduce depressive symptoms, suicide ideation, and disability at a 28-week follow-up period.
Study Details
Timeline
Interventions
The care management intervention aims at facilitating adherence to a treatment algorithm based on the Agency for Health Care Policy and Research (AHCPR) guidelines. The investigators hypothesize that this intervention, in comparison to usual care, will increase the prescription of adequate antidepressant treatment by physicians, enhance treatment adherence by patients, and reduce depressive symptoms, suicide ideation, and disability.
For subjects in the Enhanced Care group, physicians providing aftercare will receive no clinical instructions by the research team, but will be informed in writing of the patients' diagnosis and will be provided with a copy of the Agency for Health Care Policy and Research (AHCPR) guidelines for the treatment of depression in primary care with an addendum updating the tables describing Selective Serotonin Reuptake Inhibitors (SSRI) side effect and dosage profiles. The investigators expect that these physicians will continue to base their practice on clinical judgment about how best to treat depression in chronic obstructive pulmonary disease patients.