FACE-PC: Family-Centered Care for Older Adults With Depression and Chronic Medical Conditions in Primary Care

Study Overview
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Brief Summary
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Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families are already involved in various aspects of self-management of chronic disease in older adults. Despite the benefits they provide, informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts.The purpose of the mentored research is to examine the feasibility and acceptability of the FACE-PC, a theory-driven, multi- component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease management. It aims to optimize the patient and family's collective ability to self-manage chronic disease.

Detailed Description
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Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families are already involved in various aspects of self-management of chronic disease in older adults. Despite the benefits they provide, informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts.The purpose of the mentored research is to examine the feasibility and acceptability of the FACE-PC, a theory-driven, multi- component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease management. It aims to optimize the patient and family's collective ability to self-manage chronic disease.

Official Title
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FACE-PC: Family-Centered Care for Older Adults With Depression and Chronic Medical Conditions in Primary Care

Conditions
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Chronic Medical Conditions, Depression

Intervention / Treatment
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* Behavioral: FACE-PC


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for Patient: 60 years of age or older Receives primary care PHQ-9 score ≥ 5 Must have at least one medical condition actively managed at the study site. Inclusion Criteria for Family: Age 18 or older Identified as family by the patient Has a minimum of twice weekly total of 4 hour face-to face contact with the patient Is willing and available to participate in the study; Has access to internet. Exclusion Criteria for Patient: Inability to understand screening and assessment questions Montreal Cognitive Assessment Scores <18 Known diagnosis of a severe chronic mental illness such as schizophrenia Meeting the criteria for bipolar disorder or schizophrenia in PRIME-MD Deemed to be a danger to self or others that may require treatment outside a primary care setting. Exclusion Criteria for Family: Institutionalized at the time of study.

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention group<br>FACE-PC comprises 3 weekly and 2 bi-weekly sessions (total 5 sessions), delivered by a bachelors' prepared nurse care manager (CM) over 8 weeks. Over the five sessions, the nurse care manager will (1) review the patient medical history and set health goals for depression and chronic condition with the dyad, (2) review all medication, the level of adherence, challenges and facilitating factors of adherence, (3) deliver brief behavioral activation therapy. | Behavioral: FACE-PC<br> <br> |
| No Intervention: Enhanced usual care group<br>Participants in this group will receive a typical primary care enhanced with reporting of their depression status and their goal for medical condition to their PCP for 8 weeks. Upon enrolment, a research nurse will review the patient medical history and identify goals for depression and a chronic condition with the dyad. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Mood assessed with Patient Health Questionnaire | Patient Health Questionnaire | at baseline, 2-months post-intervention, and 5-months follow-up |