Clinical trial NCT04839718: Evaluation of the Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Program
Official title: Evaluating the Implementation and Outcomes of the Achieving Depression and Anxiety Patient Centered Treatment (ADAPT) Collaborative Care Program in A Large, Integrated Healthcare System: A Mixed Methods Observational Study Protocol
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Depression
Anxiety
Keywords: Depression
Anxiety
Lead sponsor: Kaiser Permanente
Sponsor class: OTHER
First posted: 2021-04-09
Enrollment: 0
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: ECOLOGIC_OR_COMMUNITY
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Kaiser Permanente Northern California adult members who screen positive for depression or anxiety in primary care and are referred to treatment.

Brief summary: Depression and anxiety are increasingly common conditions for which primary care providers (PCPs) serve as the initial healthcare contact for most patients. Comorbid depression and anxiety result in higher costs, and treatment as usual, which is referrals to specialty psychiatric care, often contribute to delays in care. Collaborative psychiatric care is an evidence-based strategy to increase mental healthcare access while reducing costs. ADAPT is a novel collaborative care model. By using technology-driven appointments with providers, ADAPT increases access to mental healthcare, and reduces member wait times. This mixed methods study will assess implementation measures of the ADAPT program and the components of ADAPT related to patient mental health improvement compared to specialty mental health care. The hypothesis is that: ADAPT program will have good program reach and efficacy. We will examine program implementation and maintenance. Further, the study looks to uncover member and program characteristics that are associated with depression and anxiety remission and care utilization.


Eligibility criteria: Inclusion Criteria:

* Adult Outcomes Questionnaire (AOQ) score between 10-30
* English-Speaking

Exclusion Criteria:

* High risk for suicide defined by answer to question 9 on PHQ-9 of 1 or more
* Diagnosis of bipolar disorder
* Diagnosis of a psychotic disorder
* Dementia diagnosis
* Active substance use disorder diagnosis
* Current hospice
* Current home-based palliative care
* Residing in a skilled nursing facility
* Residing in an assisted living facility
* Non-Kaiser Permanente Member
* Established psychiatric care outside of Kaiser Permanente

Primary outcomes:
measure: Patient reach
timeFrame: through study completion, 2 years
Secondary outcomes:
measure: Member characteristics associated with depression remission
timeFrame: baseline, 3 and 6 months
measure: Member characteristics associated with anxiety remission
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Patient therapy engagement
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Patient medication provider engagement
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Patient medication engagement
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Patient psychiatry engagement
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Patient time to care
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Depression outcomes
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Anxiety outcomes
timeFrame: baseline, 3 and 6 months
measure: Efficacy: Time to clinical improvement
timeFrame: baseline, 3 and 6 months
measure: Implementation: measurement-based care
timeFrame: through study completion, 2 years
measure: Implementation: Diagnosis
timeFrame: through study completion, 2 years
measure: Maintenance: Measurement-based care
timeFrame: through study completion, 2 years
measure: Maintenance: Diagnosis
timeFrame: through study completion, 2 years
Other outcomes:
Locations:
city: Oakland
country: United States
facility: Kaiser Permanente Northern California Division of Research
state: California
Study officials:
affiliation: Kaiser Permanente
name: Kathryn K Erickson-Ridout, MD PhD
role: PRINCIPAL_INVESTIGATOR
References: