Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: The Efficacy of Telemedicine for Improving Depression Outcomes in Primary Care
Brief Summary: 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.


Options:
A: Arm Label: 001; Type: EXPERIMENTAL; Interventions: Drug: paliperidone palmitate | Arm Label: 002; Type: ACTIVE_COMPARATOR; Interventions: Drug: aripiprazole | Arm Label: 003; Type: ACTIVE_COMPARATOR; Interventions: Drug: haloperidole | Arm Label: 004; Type: ACTIVE_COMPARATOR; Interventions: Drug: olanzapine | Arm Label: 005; Type: ACTIVE_COMPARATOR; Interventions: Drug: paliperidone | Arm Label: 006; Type: ACTIVE_COMPARATOR; Interventions: Drug: perphenazine | Arm Label: 007; Type: ACTIVE_COMPARATOR; Interventions: Drug: quetiapine | Arm Label: 008; Type: ACTIVE_COMPARATOR; Interventions: Drug: risperidone | Intervention Type: DRUG; Name: paliperidone; Assigned to Arm(s): 005 | Intervention Type: DRUG; Name: risperidone; Assigned to Arm(s): 008 | Intervention Type: DRUG; Name: haloperidole; Assigned to Arm(s): 003 | Intervention Type: DRUG; Name: perphenazine; Assigned to Arm(s): 006 | Intervention Type: DRUG; Name: aripiprazole; Assigned to Arm(s): 002 | Intervention Type: DRUG; Name: quetiapine; Assigned to Arm(s): 007 | Intervention Type: DRUG; Name: paliperidone palmitate; Assigned to Arm(s): 001 | Intervention Type: DRUG; Name: olanzapine; Assigned to Arm(s): 004
B: Arm Label: Computerized Decision Support System (CDSS); Type: EXPERIMENTAL; Interventions: Other: Computerized Decision Support System | Arm Label: Treatment as usual; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: Computerized Decision Support System; Assigned to Arm(s): Computerized Decision Support System (CDSS)
C: Arm Label: CBT no choice; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Cognitive behavioral therapy (CBT) | Arm Label: CBT choice; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Cognitive behavioral therapy (CBT) | Arm Label: sertraline no choice; Type: ACTIVE_COMPARATOR; Interventions: Drug: Sertraline | Arm Label: sertraline choice; Type: ACTIVE_COMPARATOR; Interventions: Drug: Sertraline | Intervention Type: DRUG; Name: Sertraline; Assigned to Arm(s): sertraline choice, sertraline no choice | Intervention Type: BEHAVIORAL; Name: Cognitive behavioral therapy (CBT); Assigned to Arm(s): CBT choice, CBT no choice
D: Arm Label: Shared Decision Making; Type: EXPERIMENTAL; Interventions: Behavioral: Shared Decision Making | Arm Label: Usual Care; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Shared Decision Making; Assigned to Arm(s): Shared Decision Making

Answer: B